A client fell 20 feet (6.1 meters) from the tree stand while deer hunting, sustaining a ruptured spleen. The client is receiving blood and fluid replacement while being prepared for a splenectomy. Which finding should the practical nurse (PN) report to the charge nurse?

Choice A reason: Smoking two packs of cigarettes a day is highly significant in planning the client's rehabilitation following a myocardial infarction. Smoking is a major risk factor for cardiovascular disease, and continuing to smoke can significantly hinder recovery and increase the risk of future cardiac events. Addressing this behavior is crucial for improving the client's long-term health outcomes. Smoking cessation should be a primary focus of the rehabilitation plan, and the client should be provided with resources and support to quit smoking, such as counseling, nicotine replacement therapy, or medications.
Choice B reason: Expressing a desire to change one's lifestyle is a positive and encouraging sign. It indicates the client's motivation to adopt healthier habits, which is essential for successful rehabilitation. However, while this is important, the immediate focus should be on addressing specific risk factors, such as smoking, that have a direct and significant impact on the client's recovery and future health. The desire to change is a valuable component of the rehabilitation process, but it should be coupled with targeted interventions to address critical behaviors like smoking.
Choice C reason: Drinking 1 to 2 glasses of red wine daily may have both positive and negative health implications. Moderate alcohol consumption has been suggested to have some cardiovascular benefits, but it can also pose risks, especially if not monitored. While this information is relevant to the client's overall lifestyle, it is not as immediately critical as addressing smoking, which has a well-documented and direct impact on cardiovascular health. The client's alcohol consumption can be discussed as part of the broader lifestyle changes during rehabilitation.
Choice D reason: Walking four city blocks to work each day indicates a level of physical activity that is beneficial for cardiovascular health. Encouraging regular physical activity is an essential part of the rehabilitation process. However, compared to the impact of smoking, this information is less critical in the immediate planning of the client's rehabilitation. The focus should be on eliminating harmful behaviors like smoking, while also promoting continued and possibly increased physical activity as part of a comprehensive rehabilitation plan.

Choice A reason: Carrying the phone number of the Epilepsy Foundation at all times is helpful for accessing support and information, but it does not directly prevent seizure episodes. It is more of an additional resource rather than a preventive measure.
Choice B reason: Staying well rested and avoiding a large caffeine intake is crucial for managing seizure disorders. Lack of sleep and excessive caffeine can trigger seizures in some individuals. Ensuring adequate rest and limiting caffeine consumption can help reduce the likelihood of seizure episodes.
Choice C reason: Avoiding flashing lights and excessive visual stimuli is important for individuals with seizure disorders, as these can be potential triggers for seizures. Sensitivity to visual stimuli can lead to photosensitive epilepsy, making it essential to minimize exposure to such triggers.
Choice D reason: Seeking a safe place if sensing dizziness or sensory disturbances is vital for preventing injury during a seizure. Recognizing early warning signs and finding a safe environment can help protect the individual from harm during a seizure episode.
Choice E reason: Generic medications are generally considered safe to substitute for trade name brands, but it is essential to consult with a healthcare provider before making any changes to medication. Ensuring consistency in medication and avoiding abrupt changes is crucial for managing seizure disorders effectively.