A diabetic client states he feels depressed, is complaining of chest pain, and has an open wound. Which of these complaints would require an immediate focused assessment?

Choice A reason: This is not the correct answer because reassessing the patient is not the next step after completing an assessment. Reassessment is done periodically or when there is a change in the patient's condition, but not immediately after the initial assessment.

Choice B reason: This is not the correct answer because writing nursing interventions is not the next step after completing an assessment. Nursing interventions are the actions that the nurse plans and implements to achieve the desired outcomes for the patient. They are based on the nursing diagnoses, which are derived from the analysis of the assessment data.

Choice C reason: This is the correct answer because analyzing cues is the next step after completing an assessment. Analysis is the process of identifying patterns, relationships, and trends in the assessment data, and comparing them with the normal and expected findings. Analysis helps the nurse to identify the patient's problems, needs, strengths, and risks.

Choice D reason: This is not the correct answer because creating SMART goals is not the next step after completing an assessment. SMART goals are the specific, measurable, achievable, realistic, and time-bound outcomes that the nurse and the patient agree on. They are based on the nursing diagnoses, which are derived from the analysis of the assessment data.

Choice A reason: I try to walk in the hallway each day with assistance is a correct statement. Walking is a form of physical activity that can stimulate bowel movements and prevent constipation. Walking also has other benefits such as improving circulation, muscle strength, and mood. The patient should be encouraged to walk as much as possible with assistance to prevent falls and injuries.

Choice B reason: I need to increase fiber in my diet and drink more water is a correct statement. Fiber is a type of carbohydrate that is not digested by the body and helps to form soft and bulky stools. Fiber can be found in foods such as fruits, vegetables, whole grains, nuts, and seeds. Water is essential for hydration and helps to soften the stools and ease their passage. The patient should be advised to consume at least 25 grams of fiber and 8 glasses of water per day to prevent constipation.

Choice C reason: I take my laxative every morning and an enema every night is an incorrect statement that requires follow-up teaching by the nurse. Laxatives and enemas are medications that are used to treat constipation by stimulating or lubricating the bowel. However, they should not be used routinely or excessively, as they can cause side effects such as dehydration, electrolyte imbalance, abdominal cramps, diarrhea, or dependence. The patient should be instructed to use laxatives and enemas only as prescribed by the doctor and for a short period of time. The patient should also be informed of the potential risks and complications of overusing laxatives and enemas.

Choice D reason: The pain medication I take tends to make my constipation worse is a correct statement. Pain medications, especially opioids, can slow down the movement of the bowel and cause constipation. This is a common and expected side effect of pain medications. The patient should be educated on how to manage constipation caused by pain medications, such as increasing fiber and water intake, exercising regularly, and using stool softeners or laxatives as needed. The patient should also be reassured that constipation does not mean that the pain medication is not working or that they are addicted to it.