A nurse is providing preoperative teaching to a client about promoting circulation during the postoperative period.

Which of the following instructions should the nurse include?

Choice A reason:

Substitute tobacco use with an electronic cigarette Electronic cigarette, also known as e-cigarettes or vapes, are not recommended as a primary treatment for nicotine withdrawal. While they may be considered less harmful than traditional tobacco products, their long-term safety and effectiveness in helping individuals quit smoking are still a subject of debate and research. It is generally better to opt for proven nicotine replacement therapies, such as nicotine gum, patches, lozenges, or other medications approved by healthcare providers for smoking cessation.

Choice B reason:

Limitin use of nicotine gum to 6 months is the correct choice. When discussing treatment options with a client experiencing nicotine withdrawal, the nurse should include the information that the use of nicotine gum should be limited to 6 months. Nicotine gum is a form of nicotine replacement therapy (NRT) used to help individuals quit smoking by reducing withdrawal symptoms and cravings.

However, prolonged use of nicotine gum can lead to its own dependence on nicotine, which is counterproductive to the goal of quitting smoking altogether. The use of NRT is typically recommended for a limited duration, and the goal is to gradually reduce the dosage over time until the individual can comfortably quit nicotine use altogether.

Choice C reason:

Using progressively larger nicotine patches Using progressively larger nicotine patches is not a recommended approach for nicotine withdrawal. Nicotine patches are available in different strengths, and the appropriate dosage should be determined based on the individual's smoking history and nicotine dependence. Starting with the appropriate strength and gradually reducing the dosage over time is the preferred approach to help clients quit smoking.

Choice D reason:

Using up to 40 nicotine lozenges per day the use of nicotine lozenges should be guided by the instructions provided with the product or as prescribed by a healthcare provider. It is not advisable to exceed the recommended dosage. Using excessive amounts of nicotine lozenges or any other NRT product can lead to nicotine toxicity and other adverse effects.

Choice A reason

The client is observed displaying a shuffling gait while walking in the hall is the correct answer. The nurse should recognize that observing a shuffling gait in a client who is taking antipsychotic medication is an adverse effect that must be reported to the healthcare provider. A shuffling gait is a movement disorder known as parkinsonism, which can be a side effect of some antipsychotic medications, particularly first-generation or typical antipsychotics.

Parkinsonism includes symptoms similar to Parkinson's disease, such as a shuffling walk, muscle stiffness, tremors, and difficulty with balance and coordination. It can occur as a result of blocking dopamine receptors in the brain, leading to an imbalance in dopamine levels.

Choice B reason:

The client mumbling quietly while alone is not correct because in the day room may be related to the symptoms of schizophrenia, and it does not indicate an adverse effect of the antipsychotic medication.

Choice C reason:

The client feeling light-headed when standing up quickly is not correct and it may be related to postural hypotension, which can be a side effect of some antipsychotic medications. While it should be monitored and reported if persistent or severe, it is not as urgent as reporting a shuffling gait.

Choice D reason:

The client stating that being in the sun hurts their eyes does not necessarily indicate an adverse effect of the antipsychotic medication. It may be related to other factors or unrelated to the medication.