A nurse is reviewing the medical record of a client who had abdominal surgery 2 days ago. The nurse should identify that which of the following findings indicates the client is at risk for delayed wound healing?

Rationale:
A. Establish alternatives to verbal conversation: Expressive aphasia affects a person’s ability to produce speech, so using alternative communication methods—such as picture boards, writing tools, or gestures—helps the client express needs effectively.

B. Provide educational materials with large print: Large-print materials are helpful for clients with visual impairments, not speech difficulties. Since expressive aphasia is a language production disorder, adjusting text size does not facilitate communication or address the underlying deficit.

C. Use a mechanical voice amplifier: A voice amplifier is beneficial for clients who can speak but have weak vocal strength, such as those with vocal cord paralysis. It is ineffective for clients with expressive aphasia because the issue lies in word formation, not vocal volume.

D. Have the client's glasses brought from home: Glasses improve visual acuity but do not address the client’s difficulty in forming words or sentences. While ensuring clear vision is supportive, it does not directly enhance the client’s ability to communicate verbally.

Rationale:
A. Instruct the parent to give the infant water every 3 hr between feedings: Giving water to infants under 6 months can displace nutrient intake and increase the risk of hyponatremia. Breast milk or formula should remain the exclusive source of nutrition at this age.

B. Recommend the parent mix the milk with rice cereal for feedings: Introducing rice cereal at 3 months is not developmentally appropriate and can increase the risk of choking. Cow’s milk lacks the proper nutrient balance, and adding cereal does not correct these deficiencies.

C. Instruct the parent to give 5 mcg of vitamin D daily: While vitamin D supplementation is important for infants, the concern in this scenario is the use of cow’s milk, not vitamin D deficiency. Breastfed infants should receive supplementation, but formula-fed infants typically get adequate vitamin D through fortified formula.

D. Advise the parent to avoid giving cow's milk to the infant prior to 1 year of age: Cow’s milk should not be introduced before 12 months because it lacks iron, vitamin E, and essential fatty acids, and can cause gastrointestinal irritation and occult blood loss.