A nurse is caring for an older adult client who states, "I can't pay for my care because my kid took all my money." Which of the following actions should the nurse take?

A. "I never did anything to deserve this.": This statement reflects feelings of anger and unfairness, which are characteristic of the anger stage of grief. The client is focusing on perceived injustice rather than attempting to negotiate or make promises to change outcomes.

B. "I'm going through a rough time, but things will improve.": This statement demonstrates hopefulness and optimism, which aligns more with denial or an attempt at coping. It does not indicate bargaining or negotiating to delay or change the outcome of the terminal illness.

C. "I need to see my child graduate from college before I go.": This statement reflects the bargaining stage of grief, where the client may make promises or set conditions in an attempt to postpone death or alter the outcome. It often involves “if only” thinking or focusing on specific events they hope to witness.

D. "I need to update my will as soon as possible.": Preparing legal documents or organizing affairs reflects acceptance of the terminal illness rather than bargaining. The client is acknowledging the inevitability of death and planning accordingly, which aligns with the acceptance stage of grief.

A. "I will sleep on a soft mattress.": A soft mattress does not provide adequate joint support and may allow excessive joint flexion, increasing stiffness and discomfort in osteoarthritis. Firm or supportive surfaces help maintain proper spinal alignment and reduce mechanical stress on weight-bearing joints.

B. "I will apply a heating pad to make my hands feel better.": Heat therapy promotes vasodilation, increases blood flow, and relaxes periarticular muscles, which can reduce stiffness and improve joint mobility in osteoarthritis. Application of warm compresses or heating pads is particularly beneficial before activity to decrease morning stiffness and enhance range of motion.

C. "I will take aspirin on an empty stomach.": Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate the gastric mucosa by inhibiting prostaglandin synthesis, increasing the risk of gastritis and gastrointestinal bleeding. Taking these medications with food or milk reduces gastric irritation.

D. "I will exercise my joints as much as I can when they are inflamed.": During periods of acute inflammation, excessive joint use can worsen pain and tissue irritation. Low-impact, regular exercise is encouraged, but it should be balanced with rest during flare-ups to prevent additional joint stress and exacerbation of symptoms.