A nurse is caring for a client who has terminal cancer. The client tells the nurse, "I don't want any more treatment: just make me comfortable." The nurse should document that the client is in which of the following stages of grief?

Rationale

A. Apply a transfer belt to the client prior to transferring to the stretcher: Transfer belts are used for clients who can stand or provide some degree of weight-bearing support. An immobile 104.3-kg client cannot safely assist with the transfer, making the belt ineffective and unsafe. Using a transfer belt in this scenario increases the risk of falls and caregiver injury.

B. Move the client onto the stretcher using a slide board with the assistance of two health care workers: A slide board reduces friction and allows the client to be moved laterally as a single unit, which is the safest method for an immobile client of this weight. Using at least two trained staff members prevents strain and ensures coordinated movement.

C. Have the client roll onto a transfer board and pull the board onto the stretcher: This technique requires the client to participate by rolling, which is not feasible for someone who is immobile. Pulling a transfer board with the client on it creates unnecessary shear forces that increase the risk of skin breakdown. This approach is neither safe nor appropriate for a heavy, immobile patient.

D. Move the client's upper body onto the stretcher first: Moving the client unevenly in sections can cause spinal misalignment and increases the risk of caregiver injury due to poor body mechanics. This technique also creates friction on the client’s skin and may cause discomfort or tissue injury. A coordinated lateral transfer keeps the body aligned and is recommended.

Rationale

A. Guided imagery: Guided imagery is a relaxation technique that uses mental visualization to reduce anxiety and promote calmness. It is safe, noninvasive, and can be implemented immediately before surgery to help the client manage preoperative stress.

B. Acupuncture: While acupuncture may help with pain or anxiety, it requires a trained practitioner and time to perform. It is not practical as a short-term intervention immediately prior to surgery.

C. Herbal medicine: Herbal remedies are not recommended immediately before surgery because they can interact with anesthesia and other medications, potentially increasing bleeding risk or affecting drug metabolism. Safety concerns limit their use in the preoperative period.

D. Magnet therapy: Magnet therapy lacks evidence for reducing anxiety and is not a standard complementary therapy for preoperative stress. Recommending it would not provide meaningful benefit for surgical preparation.