The practical nurse (PN) is feeding a 2-month-old male infant with heart failure due to a ventricular septal defect (VSD). Which intervention should the PN implement?

Based on the laboratory data, the client has:

Option 1: Pre-diabetes

Option 2: Impaired glucose tolerance

The client's fasting blood glucose level of 122 mg/dL (6.8 mmol/L) falls within the range of 100 to 125 mg/dL (5.56 to 6.9 mmol/L), indicating impaired glucose tolerance. This suggests that the client's blood sugar levels are higher than normal but not high enough to be classified as diabetes mellitus.

Impaired glucose tolerance is considered a precursor to diabetes and indicates an increased risk of developing diabetes in the future. It is important for the practical nurse to educate the client about lifestyle modifications to manage blood sugar levels and prevent the progression to diabetes.

- A mastectomy is a surgical procedure that involves the removal of all or part of the breast, usually to treat breast cancer. A mastectomy can have a significant impact on a woman's physical, emotional, and psychological well-being, as it may affect her body image, self-esteem, sexuality, and identity.
- A mastectomy incision is the wound that results from the surgery, which may vary in size, shape, and location depending on the type and extent of the mastectomy. The incision may be closed with stitches, staples, or glue, and covered with a dressing or bandage.

- The first dressing change is usually done within 24 to 48 hours after the surgery, and it involves removing the old dressing, inspecting the incision for any signs of infection or complications, cleaning the wound, applying a new dressing, and educating the client about wound care .
- When the practical nurse (PN) tells the client that her mastectomy incision is healing well, but the client refuses to look at the incision and refuses to talk about it, this may indicate that the client is experiencing denial, fear, anger, grief, or depression due to the loss of her breast. These are normal and common reactions that may occur at different stages of the recovery process.
- The best response by the PN to the client's silence is to acknowledge and respect the client's feelings, provide support and reassurance, and offer assistance when needed. This will help to establish trust and rapport with the client, as well as promote her coping and adjustment.
- Therefore, option A is the best answer, as it shows empathy and respect for the client's feelings, while also informing the client that the PN will be available when she is ready to look or talk about the mastectomy. Option A also implies that the PN will not pressure or force the client to do something that she is not comfortable with.

- Options B, C, and D are incorrect answers, as they do not show empathy or respect for the client's feelings, and they may cause more harm than good.