A nurse is reinforcing teaching with a client who will collect stool specimens at home for fecal occult blood testing. Which of the following foods should the nurse instruct the client to avoid for 3 days before the test?

Rationale:

• Write the full date on the client's whiteboard: Writing the date helps reinforce orientation to time, which the client is lacking. Visual cues are essential for reorienting clients with delirium. This simple step can reduce confusion and distress.

• Acknowledge the client's feelings: Acknowledging the client’s fear builds trust and therapeutic rapport. It reduces agitation and reassures the client when they experience hallucinations. Validation helps calm the client without reinforcing delusions.

• Request that the client's family bring the client's eyeglasses from home: Requesting the glasses improves the client’s ability to recognize surroundings. Visual impairment worsens confusion in older adults. Familiar visual aids reduce cognitive strain.

• Request that the client have the same caregivers with every shift: Consistent caregivers help the client form familiar relationships. Continuity reduces confusion, especially in clients with dementia or delirium. Routine and predictability lower anxiety.

• Reorient the client often: Frequent reorientation is key in delirium management. It helps the client regain understanding of time, place, and situation. Repetition promotes memory and reduces disorganized thoughts.

• Ask the client's partner to stay with the client as much as possible: The partner provides emotional comfort and familiarity. Their presence helps maintain the client’s orientation and decreases agitation. Family members often support communication and reorientation.

• Provide the client with information about what to expect during their care: Detailed information may overwhelm or confuse a delirious client. Cognitive overload can worsen disorientation. Simpler, brief explanations are more effective.

• Maintain a well-lit environment: Bright lighting may worsen hallucinations or cause overstimulation. Soft, ambient lighting is better suited for reducing visual misperceptions. Delirious patients benefit from calm, low-stimulation environments.

Rationale:

A. Respiratory acidosis: Chronic diarrhea typically causes metabolic acidosis due to loss of bicarbonate in the stool, not respiratory acidosis. Respiratory acidosis results from hypoventilation and CO₂ retention, unrelated to diarrhea.

B. Hypertension: Chronic diarrhea often leads to fluid and electrolyte imbalances causing hypotension or low blood pressure due to dehydration, rather than hypertension.

C. Hypokalemia: Diarrhea causes significant potassium loss through the gastrointestinal tract, leading to hypokalemia. Low potassium levels can result in muscle weakness, cramps, and cardiac arrhythmias.

D. Hypermagnesemia: Magnesium is usually lost during diarrhea, which more commonly leads to hypomagnesemia rather than elevated magnesium levels. Hypermagnesemia is rare unless there is excessive intake or renal failure.