A nurse is preparing to provide discharge teaching for an adolescent who has a cognitive disorder and their parents.
Which of the following actions should the nurse take?

Choice A rationale:

Charting by exception (CBE) is a documentation method in which the nurse documents only unexpected findings or significant deviations from the client's normal condition. It is based on the assumption that the client's baseline status remains within the expected range, and deviations from this norm are documented. CBE is efficient and allows nurses to focus on relevant and critical information, reducing unnecessary documentation. It is particularly useful in clinical settings where frequent assessments are needed.

Choice B rationale:

Focus charting (DAR) is another method of documenting client care that emphasizes a structured approach to documentation, with a focus on data, action, and response (DAR). While it provides a systematic way to document care, it does not necessarily limit documentation to only unexpected findings. Focus charting encourages documentation of care in a problem-oriented manner, which may include expected or routine assessments.

Choice C rationale:

Problem-oriented medical record (POMR) is a documentation system that focuses on organizing client information around specific healthcare problems or diagnoses. It encourages a problem-solving approach to care and promotes the inclusion of a comprehensive client history and care plan. POMR documentation may involve both expected and unexpected findings, so it does not limit documentation to only unexpected findings.

Choice D rationale:

SOAP documentation stands for Subjective, Objective, Assessment, and Plan. It is a structured method of documenting healthcare encounters. SOAP notes include a wide range of information, including both subjective (patient's description of symptoms) and objective (clinician's observations) data. While SOAP notes are organized, they do not specifically limit documentation to only unexpected findings.

Choice A rationale:

Ensuring that the television is on is not a recommended action when providing discharge teaching for an adolescent with a cognitive disorder and their parents. Television noise can be distracting and may hinder effective communication. The focus should be on clear, concise, and tailored communication to address the patient's and family's needs.

Choice B rationale:

Using short directive statements is a suitable approach when teaching a patient with a cognitive disorder and their parents. Patients with cognitive disorders may have difficulty processing complex information, so using concise and straightforward language can enhance understanding. It is essential to adapt teaching strategies to the individual's needs and abilities.

Choice C rationale:

Including medical slang in the teaching is not appropriate, as it can confuse and alienate patients and their families. The goal of discharge teaching is to ensure that the information provided is clear, easily understood, and accessible to the patient and their family. Using medical jargon or slang may hinder this objective.

Choice D rationale:

Including abstract imagery is not recommended when teaching a patient with a cognitive disorder. Abstract imagery can be challenging to understand, especially for individuals with cognitive impairments. Teaching materials should be concrete, straightforward, and tailored to the patient's cognitive abilities and comprehension levels.