A nurse is teaching dietary guidelines to a client who has celiac disease.
Which of the following food choices is appropriate for this client?

Choice A rationale:

Identifying possible precipitating factors related to the infections is the first step in addressing the issue of increased catheter infections. Understanding the potential causes, such as poor catheter insertion techniques, inadequate hygiene practices, or contaminated equipment, can help the nurse pinpoint the areas that need improvement. By identifying these factors, the nurse can implement targeted interventions to prevent future infections.

Choice B rationale:

Meeting with providers to discuss measures to decrease infections is a valid step, but it should come after identifying the specific factors contributing to the infections. Without a clear understanding of the root causes, the discussion with providers may lack focus and may not lead to effective solutions.

Choice C rationale:

Revising the current policy for catheter care can be considered after identifying the precipitating factors. Policy revision should be based on evidence-based practices and a thorough understanding of the issues contributing to the infections. Simply revising the policy without addressing the underlying causes may not lead to significant improvements.

Choice D rationale:

Scheduling nursing staff training for infection control procedures is an important step in preventing infections, but it should also follow the identification of specific issues related to the catheter infections. Training programs can be tailored to address the identified problems and provide targeted education to the staff members involved.

The correct answer is: b. “Tighten your muscles before relaxing them when using muscle relaxation techniques.”

Rationale for Choice B: Progressive Muscle Relaxation (PMR) is a well-established technique used in stress management and relaxation therapy. It involves systematically tensing and then relaxing specific muscle groups throughout the body. By tensing the muscles first, individuals can become more aware of the contrast between tension and relaxation, thereby enhancing the relaxation response. This heightened awareness helps individuals recognize and release muscular tension more effectively, leading to deeper relaxation and stress relief.

Rationale for Choice A: Choice A suggests talking to someone admired as the first step in using mindfulness techniques to relax. However, mindfulness practices typically involve cultivating awareness of the present moment without judgment. While seeking support from others may be beneficial for stress management, it is not a foundational aspect of mindfulness practice. Mindfulness often entails individual introspection and observation of one's thoughts, feelings, and bodily sensations.

Rationale for Choice C: Choice C recommends breathing in through the mouth and out through the nose during deep breathing exercises. While there are various breathing techniques utilized in stress management, the typical recommendation for deep breathing exercises is to inhale through the nose and exhale through the mouth. Nasal breathing helps regulate the flow of air, optimizes oxygen exchange, and activates the parasympathetic nervous system, promoting relaxation and stress reduction.

Rationale for Choice D: Choice D proposes imagining a stimulating situation when practicing guided imagery. However, guided imagery is a relaxation technique that involves creating vivid mental images of calming and tranquil scenes, such as a serene beach or peaceful forest. The purpose of guided imagery is to evoke positive emotions, reduce stress, and induce a state of deep relaxation. Imagining stimulating situations may have the opposite effect, potentially increasing arousal and tension rather than promoting relaxation.

In summary, while all choices may have some relevance to stress management, Choice B is the most appropriate as it aligns with the established technique of Progressive Muscle Relaxation. Choices A, C, and D deviate from widely recognized relaxation methods and are therefore considered incorrect in this context.