A nurse is planning to teach a client about taking prednisone.

Which of the following instructions should the nurse include?

This is because anticipatory guidance is a type of health teaching that involves sharing information and experiences through educational activities designed to improve health knowledge, attitudes, behaviors, and skills. Anticipatory guidance helps parents to prevent or reduce health problems in their children by providing them with information on topics such as nutrition, immunization, injury prevention, and developmenta milestones. Providing anticipatory guidance classes through public schools is an example of a population-based public health intervention that aims to improve the health of a large group of people who share common characteristics or risks.

Choice A is wrong because tertiary health interventions are not the best way to improve health for the local population. Tertiary health interventions are those that focus on treating and rehabilitating people who have already developed a disease or disability. They are more costly and less effective than primary or secondary health interventions, which aim to prevent or detect diseases early.

Encouraging rural residents to focus health spending on tertiary health interventions would not address the underlying causes of poor health in the community.

Choice B is wrong because having a nurse from outside the community provide health lectures at the county hospital is not a culturally appropriate or accessible way to deliver health education. A nurse from outside the community may not understand the needs, values, beliefs, and practices of the rural residents, and may not be able to establish trust and rapport with them. Moreover, the county hospital may not be a convenient or comfortable location for many rural residents to attend health lectures, especially if they have transportation, financial, or time barriers.

A better approach would be to involve local community members and leaders in planning and delivering health education programs that are tailored to the rural context and culture.

Choice D is wrong because launching a media campaign to increase awareness about industrial pollution is not a sufficient action to improve health for the local population. While increasing awareness is an important first step, it does not necessarily lead to behavior change or environmental improvement.

A media campaign alone would not address the sources and effects of industrial pollution, nor would it provide solutions or resources for the rural residents to protect themselves from exposure.

A more comprehensive action would be to collaborate with other stakeholders, such as environmental agencies, industry representatives, and community groups, to develop and implement strategies for reducing and monitoring industrial pollution and its impact on the environment.

B, C, and D. These findings require follow-up because they indicate possible complications of chemotherapy, such as infection, low blood cell counts, and lung damage.

Choice B is correct because a temperature of 38.6° C (101.5° F) is a sign of fever, which can indicate an infection. Chemotherapy can weaken the immune system and make the client more prone to infections.

Choice C is correct because a WBC count of 3,800/mm3 is below the normal range of 5,000 to 10,000/mm3 and indicates leukopenia, a condition of low white blood cells. Chemotherapy can cause leukopenia by damaging the bone marrow where blood cells are produced.

Choice D is correct because crackles heard at the bases of the lungs are abnormal breath sounds that can indicate fluid accumulation or inflammation in the lungs. Chemotherapy can cause lung damage by affecting the cells that line the airways or by triggering an immune response.

Choice A is wrong because a potassium level of 3.6 mEq/L is within the normal range of 3.5 to 5 mEq/L and does not require follow-up.

Choice E is wrong because a blood pressure of 114/56 mm Hg is within the normal range of less than 120/80 mm Hg and does not require follow-up.