The nurse is changing a client’s dressing. Which observation warrants immediate physician notification?

Choice A reason: Restating is a therapeutic communication technique that involves repeating or paraphrasing what the client has said to show understanding and clarify meaning. It is not an appropriate intervention to provide comfort during a painful procedure, especially when the client does not speak English. Therefore, this choice is incorrect.

Choice B reason: Listening is a therapeutic communication technique that involves paying atention and showing interest in what the client has to say. It is an important skill for building rapport and trust, but it is not an effective intervention to provide comfort during a painful procedure, especially when the client does not speak English.

Therefore, this choice is incorrect.

Choice C reason: Silence is a therapeutic communication technique that involves allowing pauses or gaps in the conversation to give the client time to think, reflect, or express emotions. It can be useful in some situations, but it is not a sufficient intervention to provide comfort during a painful procedure, especially when the client does not speak English. Therefore, this choice is incorrect.

Choice D reason: Touch is a nonverbal communication technique that involves using physical contact to convey empathy, support, or reassurance. It can be a powerful intervention to provide comfort during a painful procedure, as long as it is done with respect, consent, and cultural sensitivity. It can also transcend language barriers and communicate caring and compassion. Therefore, this choice is correct.

Choice A reason: Be silent as a sign of compassion is not an appropriate action for the nurse to take when a client bursts into tears. Silence can be misinterpreted as indifference, disapproval, or rejection, and it can make the client feel more isolated or uncomfortable. Therefore, this choice is incorrect.

Choice B reason: Continue with the physical preparation of the client is not an appropriate action for the nurse to take when a client bursts into tears. Continuing with the task without acknowledging the client’s emotional state can be perceived as insensitive, uncaring, or disrespectful, and it can increase the client’s anxiety or distress. Therefore, this choice is incorrect.

Choice C reason: Ask the client to share what she is feeling is an appropriate action for the nurse to take when a client bursts into tears. Asking open-ended questions can encourage the client to express her emotions, concerns, or fears, and it can show that the nurse is interested, supportive, and empathetic. It can also help the nurse to identify the source of the client’s distress and provide appropriate interventions or referrals. Therefore, this choice is correct.

Choice D reason: Pull the curtain and leave the area to provide privacy is not an appropriate action for the nurse to take when a client bursts into tears. Leaving the client alone can make her feel abandoned, ignored, or unimportant, and it can prevent the nurse from providing emotional support or assistance. Therefore, this choice is incorrect.