A nurse is reinforcing discharge teaching with a client who had an above-the-knee amputation and has a prosthesis. Which of the following Instructions should the nurse include?

A. "You will be okay.": Providing vague reassurance does not address the client’s expressed fear or delusional belief. It may minimize the client’s emotional experience and does not promote therapeutic communication. Effective responses should acknowledge the client’s feelings without validating the delusion.

B. "Feelings of persecution are normal with your condition.": Labeling the client’s experience as part of the illness can feel dismissive and may increase defensiveness. It focuses on the diagnosis rather than the client’s emotional state and does not foster trust or therapeutic rapport.

C. "It must be frightening to believe that someone is after you.": This response reflects empathy and validates the client’s emotional experience without confirming the delusional content. Therapeutic communication with clients experiencing persecutory delusions involves acknowledging feelings while avoiding reinforcement of false beliefs. This approach promotes trust and supports reality orientation.

D. "Let me check to see if it's time to take your medication.": Redirecting immediately to medication shifts focus away from the client’s expressed fear and may be perceived as dismissive. While antipsychotic medication is important in managing schizophrenia, the immediate nursing response should prioritize therapeutic communication and emotional support.

A. Oil-based lubricant: Oil-based lubricants are not recommended for nasogastric tube insertion because they can increase the risk of aspiration pneumonia if inadvertently inhaled. Water-soluble lubricants are preferred, as they are safer if aspirated and do not interfere with mucosal integrity.

B. Enteric feeding pump: An enteric feeding pump is used for controlled delivery of enteral nutrition, not for gastric decompression. Gastric decompression typically involves connecting the tube to low intermittent suction to remove air or gastric contents.

C. Sterile gloves: Clean, not sterile, gloves are generally sufficient for nasogastric tube insertion unless the client is immunocompromised or a sterile field is otherwise required. The procedure does not involve entering a sterile body cavity.

D. pH strips: pH strips are essential to verify correct placement of the nasogastric tube by testing the acidity of aspirated gastric contents. Gastric fluid typically has a pH of 5 or less, which helps confirm proper positioning before initiating suction or other interventions.