A female client reports that pain from carpal tunnel syndrome is beginning to affect her job performance. Which instruction should the nurse provide this client?

Choice A reason: Taking vitamin B6 is sometimes suggested for nerve health, but evidence for carpal tunnel syndrome relief is weak. Splinting maintains neutral wrist position, directly reducing median nerve compression, making this instruction less effective for managing work-related pain and functional impairment.

Choice B reason: Using a space heater to keep hands warm may improve comfort but does not address median nerve compression in carpal tunnel syndrome. Splinting prevents wrist flexion, directly relieving pressure, making warmth a secondary, less effective intervention for job-related pain.

Choice C reason: Elevating hands during breaks reduces swelling but does not prevent nerve compression during work. Wrist splints maintain neutral positioning, directly alleviating carpal tunnel symptoms, making elevation less effective, as it does not address repetitive strain causing job performance issues.

Choice D reason: Obtaining wrist splints is critical, as they keep wrists neutral, reducing median nerve compression in carpal tunnel syndrome. Worn during work, splints alleviate pain and improve function, directly addressing job performance issues, making this the most effective instruction for symptom management.

Choice A reason: Severe headache with photosensitivity suggests meningitis or dehydration but is less urgent than rebound tenderness, which indicates peritonitis. In acute abdominal pain, neurological symptoms are secondary to potential surgical emergencies like appendicitis, requiring immediate reporting for possible operative intervention.

Choice B reason: Right lower abdomen rebound tenderness indicates peritoneal irritation, likely appendicitis, in acute abdominal pain. This surgical emergency risks rupture, causing peritonitis or sepsis, necessitating immediate reporting to the provider for urgent imaging or surgery, making it the priority finding over other symptoms.

Choice C reason: Petechial hemorrhage under the eyes suggests coagulopathy or increased intracranial pressure but is less specific to acute abdominal pain. Rebound tenderness directly indicates a surgical emergency like appendicitis, making petechiae a secondary concern requiring evaluation after addressing peritoneal signs.

Choice D reason: Dark green emesis indicates bile or obstruction but is less urgent than rebound tenderness, which signals peritonitis. Vomiting is managed with fluids, but tenderness suggests a surgical condition like appendicitis, requiring immediate reporting to prevent complications like perforation.