A nurse is assisting with teaching a client about over-the-counter medications used to treat insomnia. The nurse should include that which of the following is an adverse reaction of diphenhydramine?

Choice A reason : Administering an opioid narcotic can be an effective measure for managing dyspnea in end-of-life care. Opioids, such as morphine, can reduce the sensation of breathlessness and improve comfort without significantly affecting oxygen saturation levels. The use of opioids is a well-established practice in palliative care for the relief of dyspnea, particularly when other causes of dyspnea have been addressed and managed appropriately.

Choice B reason : Increasing the heat in the client's room is not a recommended action for managing dyspnea and may actually worsen the client's comfort. Patients experiencing dyspnea often feel better in a cooler environment, as warm temperatures can make breathing feel more labored⁴.

Choice C reason : Placing the head of the client's bed flat is not advisable for managing dyspnea. Elevating the head of the bed can help ease breathing by reducing pressure on the diaphragm and allowing for better lung expansion. A semi-upright position, such as Fowler's or semi-Fowler's position, is typically recommended for patients experiencing dyspnea.

Choice D reason : Nasotracheal suctioning is a procedure used to clear secretions from the airway. While it may be necessary in some cases, it is not a standard action for managing dyspnea in end-of-life care unless there is a specific indication, such as excessive secretions that the patient cannot clear on their own. It can be uncomfortable and distressing for the patient and should be used judiciously⁵.

Choice A reason : Determining the success of coping strategies is an important part of the nursing process, but it is not the first step when caring for a client experiencing grief. The initial step should be to assess the client's current state, including their grieving process, before evaluating the effectiveness of past coping strategies.

Choice B reason : Establishing whether the client's grieving is healthy or complicated is the first action the nurse should take according to the nursing process. This assessment helps to identify the client's needs and guides the subsequent planning of care. Healthy grieving is a natural response to loss, whereas complicated grief may require more intensive intervention and support.

Choice C reason : Developing client-specific goals and outcomes is a crucial part of the nursing process but should come after the nurse has established a clear understanding of the client's grieving process. Goals and outcomes should be based on the initial assessment and tailored to the client's individual situation.

Choice D reason : Incorporating the treatment into the client's care is part of the implementation phase of the nursing process. This step occurs after the nurse has assessed the client, established goals, and planned interventions. Treatment should be based on a thorough understanding of the client's grieving process.