A patient about to undergo surgery is expressing anxiety. Which nurse’s response is most likely to encourage further conversation with the patient?

Choice A rationale:
Prednisone:
Corticosteroid that suppresses the immune system: It's crucial to consult with the primary healthcare provider (PCP) because prednisone can impair wound healing and increase the risk of infection after surgery. The PCP may need to adjust the dosage or temporarily discontinue prednisone prior to surgery.
Potential for adrenal insufficiency: Abrupt cessation of prednisone can lead to adrenal insufficiency, a life-threatening condition. The PCP will provide guidance on how to taper the medication safely before surgery.
Interaction with anesthesia: Prednisone can interact with certain anesthetic agents, potentially increasing the risk of complications. The PCP and anesthesiologist will need to coordinate care to ensure safe medication management during surgery.
Choice B rationale:
Metoprolol:
Beta-blocker that lowers blood pressure and heart rate: While metoprolol is generally safe to continue before surgery, it's still essential to inform the PCP and anesthesiologist about its use. They will monitor heart rate and blood pressure closely during and after surgery, as metoprolol can interact with certain medications used during the procedure.
Choice C rationale:
Warfarin:
Blood thinner that prevents blood clots: Warfarin requires careful management around surgery due to its significant bleeding risk. The PCP will typically recommend holding warfarin for several days before surgery to allow for normalization of blood clotting. They may also bridge with a shorter-acting anticoagulant if necessary.
Potential for bleeding complications: If warfarin is not managed appropriately, it can lead to excessive bleeding during or after surgery. The PCP will closely monitor the patient's INR (international normalized ratio), a measure of blood clotting, to ensure it's within the safe range for surgery.
Choice D rationale:
Insulin:
Hormone that regulates blood sugar: Patients with diabetes who take insulin require careful blood sugar control around surgery to prevent complications. The PCP will provide specific instructions on how to adjust insulin doses before, during, and after surgery, as insulin needs often change due to the stress of surgery and the impact of anesthesia.
Risk of hypoglycemia and hyperglycemia: Both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia) can have serious consequences during and after surgery. The PCP will work with the patient to manage blood sugar levels and prevent these complications.
Choice E rationale:
Phenytoin:
Anticonvulsant medication that controls seizures: Phenytoin has a narrow therapeutic window, meaning that blood levels must be closely monitored to ensure efficacy and prevent toxicity. Surgery can affect phenytoin levels, so the PCP will likely recommend checking a blood level before surgery and adjusting the dose as needed.
Potential for drug interactions: Phenytoin interacts with many medications, including some commonly used during surgery. The PCP will need to review the patient's medication list carefully and make any necessary adjustments to prevent interactions.
Choice F rationale:
Omega-3 fatty acid:
Generally safe to continue before surgery: Omega-3 fatty acids are not known to have significant interactions with medications used during surgery or to pose risks for wound healing or bleeding. However, it's always best to inform the PCP about any supplements being taken.

Choice A rationale:
It is incorrect to state that the client will not be able to bathe with a central vascular access device.
While certain precautions are necessary to keep the device dry and clean during bathing, bathing is still possible and important for maintaining hygiene.
The nurse should provide specific instructions on how to protect the device during bathing, such as using a waterproof cover or avoiding direct water contact.
Choice B rationale:
It is inaccurate to claim that there is no risk of infection associated with a central vascular access device, even when sterile technique is used during insertion.
Infection is a serious potential complication, and it's crucial to emphasize ongoing infection prevention measures to the client.
The nurse should educate the client about signs and symptoms of infection to watch for and the importance of prompt reporting to healthcare providers.
Choice C rationale:
It is not always necessary to wear a sling on the arm with the central vascular access device.
The need for a sling may depend on the type of device, the client's condition, and the healthcare provider's recommendations.
If a sling is indicated, the nurse should provide instructions on proper use and care to maintain comfort and prevent complications.
Choice D rationale:
This is the correct statement to include in the client's teaching.
Thorough cleaning of the connections prior to accessing the device is essential for preventing infection.
The client should be empowered to advocate for themselves and ensure that all providers follow proper infection control procedures.