A nurse is reinforcing teaching about toilet training with the guardians of a toddler who has a cognitive impairment. Which of the following instructions should the nurse include?

A. You wish you were no longer alive?: This response might sound accusatory and may invalidate the client's feelings. The nurse should express empathy and understanding instead of making the client feel misunderstood.

B. "It is common for people who have a terminal illness to feel that way.": This response validates the client's feelings by acknowledging the emotional distress that often accompanies a terminal illness. It normalizes the experience without minimizing it and opens the door for further discussion.

C. "Why do you wish you weren't alive any longer?": While this response is direct, it might sound too probing and may feel intrusive or dismissive of the client's emotional state. A softer, more empathetic approach is usually preferred.

D. "We should talk about the treatment plan your provider has suggested.": While discussing treatment plans is important, this response may deflect the client's emotional distress and shift the focus away from their immediate emotional needs. The nurse should first address the emotional aspect before discussing treatment.

A. "I will increase my fluid intake to 1,700 milliliters per day.": While maintaining hydration is important for people with COPD, 1,700 milliliters may not be sufficient for all individuals. Fluid intake should be tailored to the patient's needs, and the client should be advised to follow specific guidelines from their provider.

B. "I should do aerobic exercises once per day.": This is somewhat correct, as regular exercise is beneficial for people with COPD, but it should be individualized based on the client's current condition and limitations. However, exercise should not be the primary focus of initial teaching for someone newly diagnosed with COPD.

C. "I will consume low-protein, low-calorie foods.": This is incorrect. COPD clients generally need a balanced diet with sufficient protein and calories to support respiratory function and muscle strength. A low-calorie diet may contribute to weight loss and muscle wasting, which can worsen COPD symptoms.

D. "I should practice pursed-lip breathing exercises.": This is correct. Pursed-lip breathing helps to control shortness of breath, improve ventilation, and reduce the work of breathing, which is an important strategy for individuals with COPD to manage their condition.