A client with liver impairment has been prescribed a low-sodium diet to reduce fluid retention. Which meal option should the nurse recommend for this client?

A.Patient-controlled analgesia allows the client to self-administer small, predetermined doses of analgesic medication, usually opioids, to maintain a consistent therapeutic level of pain relief. This method empowers the client and addresses the subjective nature of pain more effectively than traditional nurse-administered PRN schedules. The nurse must emphasize that the client is the only person authorized to operate the device to ensure safety and prevent overdose.

B.PCA medications are typically delivered via the intravenous route or sometimes through an epidural catheter, rather than the intramuscular route. Intramuscular injections are associated with inconsistent absorption rates and local tissue trauma, making them unsuitable for the frequent, small-dose delivery required by PCA systems. The intravenous route provides immediate bioavailability and allows for precise titration based on the client's immediate analgesic needs and respiratory status.

C.PCA devices are specifically programmed to deliver small, frequent doses of medication to keep the client's pain within a manageable range while minimizing sedative side effects. Administering large doses with each injection would increase the risk of respiratory depression and profound hypotension. The system includes a lockout interval that prevents the client from receiving excessive amounts of medication, maintaining a safe balance between analgesia and drug toxicity.

D."PCA by proxy," where a family member or partner pushes the button, is strictly prohibited due to the high risk of oversedation and fatal respiratory depression. The client is the only one who can accurately gauge their level of pain and sedation; if they are asleep, they do not require a dose. The nurse must educate the family that only the client should touch the PCA button to maintain clinical safety.

A.Daily antihypertensive use manages systemic vascular resistance and cardiac output but does not inherently suppress the immune system or impair the primary phases of wound healing. While uncontrolled hypertension can affect overall surgical outcomes, it is not a direct independent risk factor for the colonization of pathogens at the incision site. The nurse should monitor blood pressure stability rather than increased infectious risk.

B.A history of deep vein thrombosis increases the client's risk for venous thromboembolism during the perioperative period due to venous stasis and hypercoagulability. However, the presence of a previous clot does not compromise the skin barrier or the cellular response required to prevent a surgical site infection. Prophylaxis for this client would focus on anticoagulation and mechanical compression rather than antimicrobial stewardship.

C.Age over 65 years old is associated with physiological changes such as decreased tissue perfusion, thinning of the dermal layer, and a naturally declining immune response known as immunosenescence. These factors collectively hinder the body's ability to clear pathogens and synthesize collagen efficiently at the surgical site. The nurse must recognize that older adults have a statistically higher incidence of postoperative infections compared to younger populations.

D.A body mass index of 23 falls within the healthy reference range of 18.5 to 24.9, indicating an appropriate nutritional status and a normal distribution of adipose tissue. Unlike obesity, which impairs blood flow to subcutaneous tissue, or malnutrition, which prevents protein synthesis, a BMI of 23 supports optimal wound healing. This finding actually suggests a lower risk for complications related to surgical site integrity.