A nurse manager finds that there has been an increase in urinary tract infections on the unit. To address this problem, which of the following actions should the nurse manager take first?

Answer is: d. "Clients are the experts on their own pain."

Explanation: The charge nurse's response acknowledges the client's self-report of pain, which is considered the most reliable indicator of pain presence and intensity. This approach emphasizes the importance of individualized pain management and respects the client's autonomy.

Statement a. is wrong because the nurse is suggesting an intervention without assessing the client's pain or consulting the healthcare provider. Although nonpharmacological interventions may be appropriate, they should be discussed with the client and provider before making decisions.

Statement b. is wrong because withholding prescribed medication without a valid reason or consultation with the healthcare provider is inappropriate and could result in inadequate pain management.

Statement c. is wrong because contacting mental health services for a consultation based on the assumption that the client is seeking drugs may be premature and overlook the client's reported pain. A thorough assessment and discussion with the healthcare provider should precede any consultation.

Choice A rationale:

A podiatrist specializes in foot-related issues. Osteoarthritis primarily affects joints, so referring the client to a podiatrist would not directly address their difficulty in buttoning clothes.

Choice B rationale:

A social worker typically addresses psychosocial needs, including emotional and financial concerns. While important, this role wouldn't directly address the client's physical difficulty with buttoning clothes due to osteoarthritis.

Choice C rationale:

Paramedical technologists are skilled in various diagnostic tests and procedures. However, they are not directly involved in assisting clients with activities of daily living or improving physical function.

Choice D rationale:

An occupational therapist (OT) specializes in helping clients regain and enhance their ability to perform daily activities, such as dressing, grooming, and self-care. For the client with osteoarthritis struggling to button clothes, an OT would assess their physical limitations and provide strategies or adaptive tools to improve independence in these activities.