A nurse is caring for a client who repeatedly refuses meals.

The nurse overhears an assistive personnel (AP) telling the client, “If you don’t eat, I’ll put restraints on your wrists and feed you.” The nurse should intervene and explain to the AP that this statement constitutes which of the following torts?

The correct answer is choice B. Use an ibuterol inhaler.

Choice A rationale:

Completing oral hygiene is important for overall health, but it is not specifically related to the preparation for postural drainage in cystic fibrosis patients. Postural drainage is a technique used to clear mucus from the lungs, and oral hygiene does not directly affect this process.

Choice B rationale:

Using a bronchodilator, such as an ibuterol inhaler, is recommended before postural drainage because it helps to open the airways, making the drainage process more effective. Bronchodilators are often used to relax the muscles around the airways, which can become constricted in conditions like cystic fibrosis.

Choice C rationale:

Taking pancrelipase is related to aiding digestion in cystic fibrosis patients who have pancreatic insufficiency. While it is an important part of the overall management of cystic fibrosis, it is not directly related to the preparation for postural drainage.

Choice D rationale:

Eating a meal before postural drainage is not recommended because a full stomach can make the process uncomfortable and less effective. It is generally advised to perform postural drainage on an empty stomach to ensure that the mucus can be cleared from the lungs more easily.

The nurse should recognize the client is experiencing preterm labor due to previous preterm birth.

Preterm labor is when regular contractions begin to open the cervix before 37 weeks of pregnancy. One of the risk factors for preterm labor is having a previous preterm delivery. The client’s history indicates that her last pregnancy resulted in a preterm spontaneous vaginal birth at 30 weeks gestation. The client’s current symptoms, such as lower back pain, pinkish vaginal discharge, uterine contractions and cervical dilation, also suggest that she is in preterm labor. Therefore, the nurse should recognize that the client is experiencing preterm labor due to previous preterm birth.

BMI, blood type and blood pressure are not causes of preterm labor in this case. BMI may be associated with preterm labor if it is too high or too low, but the client’s BMI is within the normal range for pregnancy. Blood type may cause Rh incompatibility if the mother is Rh negative and the baby is Rh positive, but the client’s blood type is Rh positive. Blood pressure may cause preeclampsia if it is too high, but the client’s blood pressure is normal. Abruptio placentae is a condition where the placenta separates from the uterine wall before delivery, which can cause vaginal bleeding, abdominal pain and fetal distress. The client does not have these signs.