A nurse is caring for a client who is postoperative.

Exhibits

Which of the following factors could present a barrier to the nurse effectively communicating with the client? Select all that apply.

A. Keep communication simple and concrete: Using simple, straightforward language helps clients who are cognitively impaired to better understand the information being conveyed. Concrete language minimizes confusion and makes it easier for the client to process and respond to what is being said, promoting effective communication.

B. Focus on the client's family: While involving the client's family can be important for support and understanding, the primary focus should be on the client themselves. Communication techniques should prioritize addressing the needs and comprehension of the cognitively impaired client directly.

C. Use open-ended questions: Open-ended questions may be challenging for cognitively impaired clients, as they require more complex processing and can lead to confusion. It is often more effective to use closed questions that allow for simple yes or no responses, making it easier for the client to engage in the conversation.

D. Demonstrate or pantomime ideas: While demonstration can be helpful, it should complement verbal communication rather than replace it. For cognitively impaired clients, combining simple verbal instructions with visual cues or demonstrations can enhance understanding but should not be the sole technique used. It’s important to assess the individual client's abilities and preferences when employing this method.

A. Instruct the patient to cough and deep breathe to prevent atelectasis: While coughing and deep breathing are important post-operative interventions to prevent respiratory complications, they are not appropriate actions in the case of wound dehiscence. Encouraging coughing could exacerbate the situation by increasing intra-abdominal pressure.

B. Apply a sterile saline dressing and notify the surgeon immediately: This is the most appropriate immediate action in the event of wound dehiscence. Applying a sterile saline dressing helps protect the exposed tissue and prevent infection, while notifying the surgeon is crucial for further evaluation and intervention. Wound dehiscence is a surgical emergency that requires prompt attention.

C. Increase the patient's oral fluid intake to promote healing: While adequate hydration is important for overall recovery, it is not an immediate action to take in response to wound dehiscence. Addressing the wound itself and notifying the surgical team is the priority in this situation.

D. Apply pressure to the wound to stop any bleeding: While it is important to control bleeding, applying pressure may not be appropriate if there is significant opening or exposure of the internal structures. Instead, the focus should be on covering the wound with a sterile dressing and seeking immediate surgical intervention to assess and manage the dehiscence.