A nurse is teaching a class at a local senior center regarding safety in the home. A client states, "I am afraid of falling because I live alone and have no one to help me." Which of the following statements should the nurse make?

Rationale:
A. Instruct the client’s partner to assume care of the colostomy for the client: Having the partner take over care may reinforce the client’s avoidance and hinder acceptance of the stoma. The goal is to promote gradual involvement and self-care.

B. Encourage the client and partner to avoid expressing negative feelings about the colostomy: Suppressing emotions can delay psychological adjustment. The nurse should instead encourage open discussion of feelings.

C. Transfer the client to a rehabilitation facility for instruction about self-management of the colostomy: Transferring the client is unnecessary at this stage and may add emotional stress. Education and emotional support can be effectively provided in the current care setting.

D. Suggest the client join a support group for people who have colostomies: Support groups provide opportunities to share experiences with others who have undergone similar surgeries. Peer support can reduce isolation, promote acceptance, and help the client adapt to lifestyle changes more confidently.

Rationale:
A. Assess the client's lung sounds prior to the infusion: Baseline lung assessment helps detect early signs of fluid overload or transfusion-associated circulatory overload (TACO), which is especially important in older adults.

B. Prime the infusion tubing with 0.45% sodium chloride: Only 0.9% sodium chloride (normal saline) is compatible with blood products. Hypotonic solutions such as 0.45% sodium chloride can cause hemolysis of red blood cells.

C. Don sterile gloves to prepare the blood administration setup: Clean gloves are sufficient for preparing and administering blood transfusions. Sterile gloves are not required unless performing a sterile procedure.

D. Verify with another nurse that the unit of blood is compatible with the client's blood type: Double verification of the client’s identity and blood compatibility prevents hemolytic transfusion reactions due to mismatched blood.

E. A single blood administration set should not be used for more than 4 hours total due to the risk of bacterial growth. More importantly, running 2 units over a single 4 hour window would mean infusing the blood far too quickly for an older adult, drastically increasing their risk of volume overload. Each unit should be scheduled separately with a careful assessment in between.