A hospice nurse is performing a home visit for a client who is being cared for by their partner. Which of the following statements made by the partner indicates the partner is experiencing denial?

Rationale:
A. "Dehydration is caused by a decreased hemoglobin and hematocrit.": Dehydration typically results in increased, not decreased, hemoglobin and hematocrit values because fluid loss concentrates red blood cells. Low values would suggest anemia or blood loss rather than dehydration.

B. "Dehydration is associated with gastroesophageal reflux.": While dehydration may worsen nausea or fatigue, it is not directly linked to gastroesophageal reflux. GERD in pregnancy is usually caused by hormonal relaxation of the lower esophageal sphincter and increased intra-abdominal pressure from the enlarging uterus.

C. "Dehydration is treated with calcium supplements.": Calcium supplements are unrelated to treating dehydration. Management focuses on restoring fluid balance through oral or intravenous hydration to maintain uteroplacental perfusion and reduce uterine irritability.

D. "Dehydration can increase the risk for preterm labor.": Dehydration leads to increased secretion of antidiuretic hormone (ADH), which can stimulate oxytocin release and uterine contractions. Correcting dehydration helps reduce uterine activity and lowers the risk of preterm labor in pregnant clients.

Rationale:
A. "I can have up to three glasses of wine per day while breastfeeding.": Alcohol passes into breast milk and can affect the infant’s neurologic development and feeding patterns. Regular alcohol intake should be avoided.

B. "I need to drink a glass of fluid each time I nurse and with all meals.": Adequate hydration supports optimal milk production during breastfeeding. Increasing fluid intake each time the mother nurses or eats helps replace fluids lost through lactation and prevents dehydration.

C. "I should avoid all seafood while I am breastfeeding.": Seafood provides essential omega-3 fatty acids that support the infant’s brain and eye development. The mother should only avoid high-mercury fish such as swordfish and king mackerel.

D. "I need to eat a bland diet while breastfeeding, as babies often react to spicy food.": Most infants tolerate varied maternal diets, including spicy foods, without adverse effects. Restricting flavors unnecessarily limits the mother’s nutrition and is not required.