A nurse is performing discharge teaching with a client who has a wound that requires home health care. Which of the following team members should the nurse contact for consultation?

A. T 38.6° C (101.5°F), oral. The client’s temperature has increased, which may indicate that the infection is progressing despite treatment. Persistent fever can contribute to dehydration, increased metabolic demand, and worsening systemic inflammation, all of which require further assessment and potential intervention.

B. Apical HR 108/min. The client’s heart rate has risen from 99/min to 108/min, which may be a compensatory response to fever, infection, or early signs of sepsis. Tachycardia combined with hypotension warrants close monitoring for worsening hemodynamic instability.

C. BP 112/54 mm Hg, supine. The blood pressure has decreased from 114/56 mm Hg to 112/54 mm Hg. While this is still within an acceptable range for some clients, the low diastolic pressure may indicate vasodilation due to sepsis or dehydration. If this trend continues or the client becomes symptomatic (e.g., dizziness, altered mental status), further intervention may be needed.

D. R 22/min. The respiratory rate has decreased from 32/min to 22/min, indicating improved respiratory status with oxygen therapy. This does not require follow-up as it falls within the normal range (12-20/min) and suggests a positive response to treatment.

E. Pulse oximetry 95% on 40% O₂ via face mask. The oxygen saturation has improved significantly from 85% on room air to 95% on supplemental oxygen. This suggests that oxygen therapy is effective, and no immediate follow-up is needed for this parameter.

F. Mucous membranes pink. The improvement from pale to pink mucous membranes indicates better oxygenation and perfusion, likely due to supplemental oxygen and improved respiratory function. This is a positive finding that does not require further intervention.

A. Asking for explanations. Asking for explanations, such as "Why did you do that?" can make a client feel defensive or judged. This approach is not therapeutic, as it may discourage open communication and trust.

B. Asking open-ended questions. Open-ended questions encourage clients to express their thoughts and feelings freely. This technique fosters meaningful dialogue and allows the nurse to gain a deeper understanding of the client’s concerns. Examples include, "Can you tell me more about how you're feeling?"

C. Offering approval or disapproval. Expressing approval or disapproval can create a sense of judgment, potentially influencing the client’s willingness to share. Therapeutic communication focuses on neutrality and support rather than personal opinions.

D. Offering sympathy. Sympathy involves expressing pity or sorrow for a client, which can create emotional distance. Instead, empathy—understanding and validating the client’s feelings—is a more effective therapeutic communication technique.