A nurse is reinforcing teaching about healthy lifestyle changes with a female client who has mild hypertension. Which of the following statements by the client indicates an understanding of the teaching?

a.Ferrous sulfateworks best when you take it on an empty stomach. However, taking ferrous sulfate on an empty stomach can actually increase the risk of gastrointestinal side effects, such as nausea. It is often recommended to take it with food to reduce nausea, even though absorption is best on an empty stomach. Thus, this statement does not indicate proper understanding.

b.Black stools are a common side effect of taking iron supplements and are usually not a cause for concern unless they are tarry or associated with other symptoms, which could indicate gastrointestinal bleeding. Reporting black stools to the doctor is typically not necessary unless the stool is tarry and has other concerning symptoms like abdominal pain or bleeding. This statement reflects a misunderstanding of common side effects.

c.Mixing ferrous sulfate elixir with a full glass of water is advisable because it helps dilute the medication, making it easier to swallow and reducing the risk of gastrointestinal irritation. This practice also ensures that the medication is taken completely. This statement indicates a correct understanding of how to take the medication properly.

d.While staying hydrated can help manage constipation, milk is not recommended with iron supplements because calcium in milk can interfere with the absorption of iron. Instead, increasing water intake, eating a high-fiber diet, and considering other dietary measures would be better advice for preventing constipation.

The correct answer is: a. Clean the stoma using an inward to outward circular motion.

Title: Choice A reason: Cleaning the stoma with an inward to outward circular motion is a recommended practice to prevent infection and ensure that any debris or secretions are cleared away from the tracheostomy site. This method helps to minimize the risk of introducing pathogens directly into the stoma and is considered a best practice in tracheostomy care.

Title: Choice B reason: Cleansing the inner cannula with isopropyl alcohol is not recommended because it can cause irritation to the tracheal mucosa. Instead, sterile saline is typically used for cleaning the inner cannula to avoid any potential damage to the tracheal tissues and to maintain a safe and comfortable environment for the patient.

Title: Choice C reason: Ensuring at least three finger widths of space under tracheostomy ties is not the standard practice. The recommended space is to allow one to two finger widths under the tracheostomy ties to ensure they are secure but not too tight, which could lead to skin breakdown or discomfort for the patient.

Title: Choice D reason: Preparing sterile supplies should be done before removing the inner cannula, not after. This is to ensure that all necessary supplies are ready to use immediately after the inner cannula is removed, minimizing the time the stoma is open and reducing the risk of infection.