A nurse is reinforcing teaching with a client who has cancer and is undergoing external radiation therapy. Which of the following instructions should the nurse include in the teaching?

A) Place the bedside table 2 feet away from the bed: This is not recommended for a client at risk for falls. The bedside table should be within reach of the client to avoid the need for excessive movement, which could increase the risk of a fall, especially if the client is unsteady or disoriented. Ideally, the bedside table should be placed within arm’s reach for convenience and safety.

B) Keep lighting in the home dim: Dim lighting increases the risk of falls by making it harder for the client to see obstacles and navigate safely. It is important to ensure that lighting is bright enough to illuminate walking areas, hallways, and other areas that might present a fall risk.

C) Place area rugs on slick floor surfaces: Area rugs on slick surfaces are hazardous as they can cause tripping or slipping, increasing the risk of a fall. It is best to remove rugs or ensure they are securely fastened to prevent them from sliding. Non-slip rugs or floor mats can be used, but they should not be placed on slick surfaces.

D) Move the client's bed to the main floor of the house: Moving the client's bed to the main floor is a good safety measure, especially if the client has difficulty navigating stairs. This reduces the need for the client to climb stairs, which can be dangerous and increase the risk of falls. Having the bed on the main floor ensures that the client can easily access their sleeping area without the risk of falling on stairs.

A) If you continue to refuse to eat, I will have to insert an NG tube: This response is coercive and may not be respectful of the client’s autonomy. It can create a sense of fear and mistrust, which can make the client feel pressured or cornered. It is important to respect the client’s beliefs and preferences while also promoting nutrition, so alternative options should be explored in a more collaborative manner.

B) Why aren't you willing to eat?: While it’s important to understand the client’s reasons for refusing to eat, this response could come across as confrontational. It may place the client on the defensive and fail to acknowledge their beliefs and autonomy. A more open-ended and supportive approach is needed to create a dialogue that is respectful and patient-centered.

C) "Your nutrition is more important than your beliefs.": This response disregards the client's personal beliefs and could be perceived as disrespectful. While nutrition is critical, it is important to work within the framework of the client’s values and beliefs. The nurse should strive for a compassionate conversation that balances nutritional needs with cultural or personal beliefs.

D) Let's discuss some menu options you would be interested in.: This response is respectful of the client’s beliefs and autonomy while still addressing the issue of malnutrition. By offering options and engaging the client in the decision-making process, the nurse fosters a collaborative approach. This can help increase the likelihood of the client agreeing to eat while respecting their preferences and beliefs.