A nurse is caring for a client who is at 31 weeks of gestation and has gestational diabetes mellitus. The client asks, "Can gestational diabetes affect my baby?" Which of the following responses should the nurse make?

A) Keep client in semi-Fowler's position with right extremity flat: Semi-Fowler's position is not optimal for a client with a compound fracture of the right tibia. Elevating the affected extremity, rather than keeping it flat, can help reduce swelling and pain.

B) Manage pain with oral opioids every 6 hr: While managing pain is crucial, oral opioids may not provide immediate relief needed in acute settings. Pain management should include a combination of strategies and may require IV analgesics for quicker relief.

C) Check capillary refill hourly for the first 24 hr: Although monitoring capillary refill is important to assess circulation, it is only one aspect of monitoring. Comprehensive assessment includes checking for signs of infection, neurovascular status, and compartment syndrome.

D) Apply a compression dressing over the fracture site: Applying a compression dressing can help control bleeding and reduce swelling. In a compound fracture, managing external bleeding and providing some stability to the fracture site are immediate priorities. However, the nurse should ensure this is done without compromising circulation and should be guided by physician orders.

A) "Tilt the spirometer toward yourself so you can see the balls rise": Tilting the spirometer is not necessary and may affect its accuracy. The spirometer should be held in an upright position to ensure correct measurement of inhalation.

B) "Inhale deeply and hold each breath for a minimum of 10 seconds": Inhaling deeply is important, but holding each breath for 10 seconds is not a typical recommendation for using an incentive spirometer. The goal is to inhale deeply and slowly, without necessarily holding the breath for an extended period.

C) "Exhale before sealing your lips around the mouthpiece": Exhaling before using the spirometer is not recommended. The correct procedure involves inhaling deeply and slowly after sealing your lips around the mouthpiece to ensure accurate measurement and effective lung expansion.

D) "Use your incentive spirometer every 4 hours while you are awake": Frequent use of the incentive spirometer, often every hour while awake, is recommended to improve lung function and prevent complications such as atelectasis. Using it every 4 hours may not be sufficient for effective respiratory therapy.