A nurse is teaching a client about meditation and progressive relaxation to reduce stress. Which of the following instructions should the nurse include?

Rationale for Correct Choices:

• A nasogastric tube: The client is experiencing nausea, vomiting, abdominal distention, and absence of bowel sounds, which are indicative of a possible postoperative ileus or bowel obstruction. Inserting an NG tube will help to decompress the stomach, prevent further buildup of gastric contents, and reduce the risk of aspiration.
• An antiemetic medication: The client is reporting nausea and vomiting, which can impede recovery and cause discomfort. Administering an antiemetic medication would help alleviate these symptoms, improve the client's comfort, and prevent complications like dehydration or electrolyte imbalances.

Rationale for Incorrect Choices:

• An indwelling urinary catheter: There is no indication of urinary retention or output issues that would require an indwelling catheter. The client has an adequate urinary output (480 mL in 8 hours), the use of a catheter could increase the risk of urinary tract infections.
• An oral airway: An oral airway is not necessary since the client is alert and oriented, with no signs of airway obstruction. The client is able to breathe adequately, and there is no indication of respiratory distress requiring airway support.
• A bladder scan: The client is not experiencing urinary retention or issues with bladder function. The urinary output is adequate, so a bladder scan is unnecessary at this time.
• Arterial blood gases: There is no indication of respiratory distress or acid-base imbalances that would require arterial blood gas analysis. The client's vital signs, including oxygen saturation and respiratory rate, are stable, and no signs of metabolic issues are present.

A. Offer a wet washcloth for the client to wash their face: Washing the face with a wet washcloth can promote relaxation and help signal to the body that it’s time to wind down. This calming routine can be soothing and may help improve the client’s ability to fall asleep.

B. Perform range-of-motion exercises: Doing range of motion exercises shortly before bedtime can be overstimulating. Physical activity close to bedtime may increase alertness and make it harder for the client to fall asleep.

C. Prepare hot cocoa or tea for the client: While warm drinks might seem comforting, caffeine in some teas or high sugar in hot cocoa can interfere with sleep. It’s important to avoid stimulants and opt for calming beverages, such as caffeine-free herbal teas, instead.

D. Provide a late supper: A large meal late at night can be disruptive to sleep as it may cause indigestion or discomfort. It’s better to encourage lighter, earlier meals to prevent any disturbances that could affect the client’s ability to fall asleep.