A nurse is reviewing the medical history of a client who is luted for surgery. Which of the following findings places the client at risk for a complication of incisional hematoma forming?

A) Denial:
Denial is the first stage in Kubler-Ross's model of grief. It typically involves a person having difficulty accepting the reality of their diagnosis or the reality of death. Clients in the denial stage may refuse to acknowledge the seriousness of their condition or may act as if everything is fine despite the obvious signs of illness. The statement “I am ready to update my will” suggests that the client has already accepted the reality of their terminal diagnosis and is preparing for what is to come, which is not characteristic of denial.

B) Acceptance:
Acceptance is the final stage in the Kubler-Ross model of grief. It is marked by coming to terms with the reality of death or a terminal diagnosis. Clients who are in the acceptance stage have typically processed their grief and are ready to make practical decisions, such as updating a will or making arrangements for the end of life. The client’s statement about updating their will reflects an acceptance of their condition and a focus on finalizing matters, which aligns with the stage of acceptance.

C) Anger:
Anger is a stage in the Kubler-Ross model of grief where individuals may feel frustrated, resentful, or upset about their situation. Clients in the anger stage may express feelings of injustice or frustration, often lashing out at others. Since the client is talking about practical matters such as updating their will, this does not indicate the emotional response of anger, which would be more likely to involve blaming others or feeling bitter.

D) Bargaining:
Bargaining is the stage where a person may make deals or promises in an attempt to delay or avoid the reality of their situation. Clients in the bargaining stage may attempt to negotiate with a higher power, themselves, or others, asking for more time or for changes in their circumstances. Since the client’s statement is about accepting the terminal diagnosis and preparing for the future, it is not indicative of bargaining, which often involves a desire for a change or a different outcome.

A) Assessment:
Assessment involves gathering and analyzing data about the client’s health status and needs. While gathering information from the social worker and physical therapist may be part of the assessment process, the actual collaborative work in preparing the discharge plan is more aligned with the planning phase of the nursing process.

B) Planning:
Planning is the correct answer because it involves formulating goals, interventions, and expected outcomes for the client’s care, including discharge projections. In this case, the nurse, social worker, and physical therapist are working together to develop a comprehensive discharge plan tailored to the client’s needs, which is a key part of the planning phase.

C) Evaluation:
Evaluation occurs after interventions are implemented to assess whether the goals have been met and the outcomes achieved. Since the nurse is still in the process of preparing the discharge plan, evaluation has not yet occurred.

D) Analysis:
Analysis is the process of interpreting assessment data to identify problems or needs. While analysis is part of the assessment phase, it does not describe the collaborative action of creating a discharge plan, which is clearly a planning task.