A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. After describing the medications that can be used as treatment, the nurse determines that additional teaching is needed when the client identifies which drug is being used.

Choice A: Call the surgeon to perform a femoral puncture. This action is not appropriate because it is unnecessary and invasive. A femoral puncture is a procedure that involves inserting a needle into the femoral vein in the groin area to obtain a blood sample. It is usually reserved for situations where other veins are inaccessible or unsuitable, such as in trauma or shock. It is not indicated for a routine CBC test.

Choice B: Assist in holding the client's arm still. This action is not appropriate because it is harmful and contraindicated. Holding the client's arm still may cause injury or infection to the arm that has undergone surgery and lymph node removal. It may also increase the risk of lymphedema, which is a condition that causes swelling and pain in the arm due to fluid accumulation and impaired lymphatic drainage.

Choice C: Tell the technician to obtain the blood sample from the client's left arm. This action is appropriate because it is safe and recommended. Obtaining the blood sample from the client's left arm can avoid complications such as injury, infection, or lymphedema in the right arm that has undergone surgery and lymph node removal. The technician can use a different site than the antecubital space, such as the hand or wrist, to avoid interfering with the intravenous line.

Choice D: Suggest a finger stick be done on one of the client's left fingers. This action is not appropriate because it is unreliable and inaccurate. A finger stick is a procedure that involves pricking the finger with a lancet to obtain a small amount of blood for testing. It is usually used for point-of-care testing, such as glucose or hemoglobin levels, but not for a CBC test. A CBC test requires a larger volume of blood and a venous sample for accurate results.

Choice A: Ask the client's English-speaking family member to translate. This action is not appropriate because it may compromise the accuracy and confidentiality of the information. The family member may not have sufficient medical knowledge or vocabulary to translate correctly or may omit or alter some details due to personal bias or embarrassment.

Choice B: Use a translation dictionary to reinforce the teaching. This action is not appropriate because it may be time-consuming and ineffective. The translation dictionary may not have all the relevant terms or phrases or may provide inaccurate or ambiguous translations. The nurse may also lose the client's attention or interest by relying on the dictionary.

Choice C: Seek assistance from a facility-approved interpreter. This action is appropriate because it ensures the quality and clarity of the communication. The facility-approved interpreter is a professional who has the skills and training to provide accurate and unbiased translation of the information. The interpreter can also facilitate the interaction and feedback between the nurse and the client.

Choice D: Ask an assistive personnel (AP) who speaks the client's language to serve as an interpreter. This action is not appropriate because it may violate the scope of practice and ethical standards of the AP. The AP may not have the qualifications or authority to provide interpretation services or may have a conflict of interest or role confusion with the client. The AP may also have other duties or responsibilities that may interfere with the interpretation process.