A nurse is reinforcing teaching with a client who is scheduled for implantation of a vagus nerve stimulator. Which of the following statements should the nurse include in the teaching?

Choice A reason: Keeping the client's bedroom area dark at night is not advisable for individuals with Alzheimer's disease who wander. Darkness can increase confusion and the risk of falls. It is better to have a night light or dim lighting to help the client navigate safely if they get up during the night. Proper lighting can reduce disorientation and provide a safer environment for those who wander.

Choice B reason: Having the client exercise 30 minutes before bedtime is not recommended. Exercise close to bedtime can be stimulating and might make it more difficult for the client to fall asleep. It is generally advised to avoid vigorous physical activity at least a few hours before bedtime to promote better sleep. Gentle activities earlier in the day can help improve sleep quality without causing overstimulation.

Choice C reason: Placing the client's mattress on the bedroom floor is a practical safety measure for clients with Alzheimer's disease who wander at night. This approach minimizes the risk of injury from falls, as the client will be closer to the ground. By reducing the height of the bed, families can create a safer sleeping environment and help prevent potential injuries due to wandering and confusion.

Choice D reason: Encouraging the client to nap often during the day can disrupt nighttime sleep patterns. Excessive daytime napping can lead to difficulties falling asleep at night and contribute to nighttime wandering. It is essential to maintain a balanced routine with limited napping during the day to promote better sleep at night. Structured activities and proper sleep hygiene can help improve nighttime rest.

Choice A reason: Opioid analgesics are not typically given before electroconvulsive therapy (ECT). Instead, a general anesthetic and a muscle relaxant are administered to ensure the patient is asleep and to prevent muscle contractions during the procedure. The nurse should inform the client about the medications they will receive before ECT, but opioid analgesics are not usually part of the protocol.

Choice B reason: Confusion and temporary memory loss are common side effects immediately following ECT. Clients should be informed to expect these cognitive effects, which can last for a few hours to days. Educating the client about these side effects helps prepare them for what to expect post-procedure and ensures they have appropriate support during their recovery period.

Choice C reason: Clients are usually instructed to fast (not eat or drink) for a shorter period, typically 6-8 hours, before the procedure to reduce the risk of aspiration during anesthesia. Informing the client to fast for 24 hours is excessive and not in line with standard preoperative fasting guidelines.

Choice D reason: A consent form is required before undergoing ECT. Informed consent is a critical component of the process, ensuring that the client understands the procedure, its benefits, risks, and potential side effects. The nurse must reinforce the importance of obtaining and signing the consent form before proceeding with ECT.