A nurse is reinforcing discharge teaching with an older adult client's family about safety precautions when administering a tap water enema to the client. Which of the following should the nurse include in the instructions?

a. Giving broad openings

The nurse is using the therapeutic technique of giving broad openings. This technique encourages the client to freely express themselves and choose the focus of the conversation. By asking, "What has been happening with you today?" the nurse is inviting the client to share their thoughts, feelings, and experiences without imposing any specific topic or direction.

Explanation for the other options:

b. Focusing: Focusing is a therapeutic technique where the nurse directs the conversation to a specific topic or issue. In this scenario, the nurse is not guiding the client's response toward a particular area of discussion.

c. Reflecting: Reflecting is a therapeutic technique where the nurse repeats or paraphrases the client's words or feelings to demonstrate understanding and encourage further exploration. The nurse's statement in this scenario does not involve reflecting the client's words or feelings.

d. Seeking clarification: Seeking clarification is a therapeutic technique used to obtain more specific information or clear up any confusion. The nurse's statement in this scenario does not involve seeking clarification from the client.

In summary, by using a broad opening, the nurse allows the client to choose the focus of the conversation

and encourages them to share their experiences and concerns.

The correct technique for using an albuterol MDI involves closing the mouth around the mouthpiece to create a seal. This helps ensure that the medication is delivered directly into the lungs and maximizes its effectiveness. It also helps prevent the medication from escaping and being wasted.

"Exhale immediately after inhaling": This instruction is not accurate. After closing the mouth around the mouthpiece and activating the inhaler to release the medication, the client should inhale slowly and deeply through the mouth, holding their breath for about 10 seconds if possible. Exhaling immediately after inhaling would not allow enough time for the medication to be absorbed effectively.

"Tilt your head forward while inhaling": Tilted head position is not necessary when using an albuterol MDI. The client should hold the inhaler in an upright position, with the mouthpiece directed toward their mouth. This allows for proper delivery of the medication.

"Take three quick breaths while depressing the canister": This instruction is not accurate for using an albuterol MDI. The correct technique involves taking a slow and deep breath in through the mouth, while simultaneously depressing the canister to release the medication. Taking three quick breaths may not allow enough time for adequate medication delivery.