A nurse is planning care for a client who wants to lose weight. Which of the following actions should the nurse take first?

A) Identify the client's motivation: Understanding the client's motivation for wanting to lose weight is crucial as it helps the nurse tailor interventions and support strategies to align with the client's goals and values. By identifying the client's motivation, the nurse can determine what drives the client's desire to lose weight, whether it's improving health, enhancing self-esteem, or addressing specific concerns. This information forms the foundation for developing an effective and individualized care plan.

B) Refer the client to a dietitian: While a referral to a dietitian is an important step in the weight loss process, it may not be the first action the nurse takes. Before making a referral, it's essential to assess the client's motivation, readiness to change, and current understanding of weight loss strategies. This information helps ensure that the dietitian can provide targeted guidance and support based on the client's specific needs and preferences.

C) Set a weight loss goal: Setting a weight loss goal is an important aspect of the weight loss journey; however, it typically occurs after assessing the client's motivation and readiness to change. Setting realistic and achievable goals collaboratively with the client allows for better engagement and commitment to the weight loss plan. Without understanding the client's motivation and readiness, setting a goal may not be meaningful or sustainable.

D) Discuss behavior modification: Behavior modification strategies play a crucial role in achieving and maintaining weight loss success. However, before discussing specific behavior modification techniques, it's essential to assess the client's motivation, barriers to change, and current behaviors. Understanding these factors helps tailor behavior modification strategies to address the client's unique needs and challenges effectively.

A) "I will eat chicken with the skin": Consuming chicken with the skin can increase saturated fat intake, which is not beneficial for heart health. The skin of poultry is high in saturated fat and cholesterol, which can contribute to elevated levels of LDL cholesterol, increasing the risk of heart disease. Therefore, this statement does not demonstrate an understanding of heart-healthy dietary choices.

B) "I will choose whole grain bread": This statement demonstrates an understanding of heart-healthy dietary choices. Whole grain bread is a good source of dietary fiber, vitamins, and minerals, and it is lower in saturated fat and cholesterol compared to refined grain products. Consuming whole grains can help lower cholesterol levels, reduce the risk of heart disease, and promote overall cardiovascular health.

C) "I should use butter for cooking vegetables": Using butter for cooking vegetables can increase saturated fat intake, which is not recommended for individuals with heart disease. High intake of saturated fats can raise LDL cholesterol levels and increase the risk of cardiovascular events. Therefore, this statement does not demonstrate an understanding of heart-healthy dietary choices.

D) "I should decrease my sodium intake to 3.2 grams per day": While reducing sodium intake is important for individuals with heart disease to manage blood pressure and reduce the risk of cardiovascular events, the recommended daily intake of sodium for most adults is less than 2.3 grams per day (equivalent to 2,300 milligrams). Some individuals, particularly those with hypertension or heart disease, may benefit from further reducing sodium intake to 1.5 grams per day. Therefore, the statement regarding sodium intake does not align with current dietary recommendations.