A nurse is providing discharge teaching to a client who has a permanent pacemaker. Which of the following statements by the client indicates an understanding of the teaching?

Rationale:

A. Crepitus at the puncture site: Crepitus, or the sensation of air under the skin, may indicate subcutaneous emphysema, which is a complication that can occur after thoracentesis. It is not a normal finding and should be reported immediately.

B. Dry, nonproductive cough: A dry, nonproductive cough is not a typical finding immediately following thoracentesis. Coughing may be associated with post-procedure irritation but should not be expected as a common outcome.

C. Increased lung expansion: Increased lung expansion is the desired outcome after thoracentesis. The procedure removes excess pleural fluid, allowing the lung to expand more fully. This is a positive result that should be expected as the client recovers.

D. Rapid, shallow respirations: Rapid, shallow respirations can indicate respiratory distress, which could signal a complication such as pneumothorax. This is not an expected finding and requires immediate evaluation and intervention.

Rationale:

A. "I will use a mirror to inspect my feet daily." People with diabetes are at risk for nerve damage, which can lead to unnoticed foot injuries or infections. Using a mirror helps to inspect the feet daily and thoroughly, especially the soles, to prevent complications.

B. "I will eat a low residue diet." A low residue diet is not recommended for diabetes management. The focus for diabetic clients should be on balanced nutrition that controls blood glucose levels rather than restricting residue unless there are gastrointestinal issues.

C. "I will take my insulin 30 minutes before exercise." Taking insulin 30 minutes before exercise could increase the risk of hypoglycemia, especially if the exercise is vigorous. It is generally recommended to adjust insulin doses or carbohydrate intake depending on the type and intensity of the exercise, under the guidance of a healthcare provider.

D. "I will limit my fluid intake to 1 liter daily." Diabetes management does not involve limiting fluid intake unless there is a specific contraindication, such as kidney disease or heart failure. Adequate hydration is important for managing blood sugar levels and preventing dehydration.