A nurse is providing discharge teaching to a client who has a Plaster of Paris walking cast on his left lower leg. Which of the following instructions should the nurse include?

Choice A reason:
Assessing the coping ability of the client is important, but it is not the immediate priority following abdominal surgery. The nurse must first ensure that the client's physiological needs are met and that there are no immediate postoperative complications.

Choice B reason:
While monitoring bowel sounds can provide valuable information about the return of gastrointestinal function, it is not the most immediate concern postoperatively. The nurse should prioritize assessments that ensure the client's safety and immediate physiological stability.

Choice C reason:
Ensuring the patency of the NG tube is the priority assessment. A patent NG tube is crucial for decompressing the stomach, preventing nausea and vomiting, and reducing the risk of aspiration, which can be life-threatening. It is also essential for the removal of gastric secretions and to prevent abdominal distention, which can compromise the surgical site and lead to complications such as wound dehiscence.

Choice D reason:
Assessing the surgical dressing is important to check for signs of bleeding or infection. However, the patency of the NG tube takes precedence as it is directly related to the client's airway and breathing, which are always the top priorities in postoperative care.

Choice A reason:
Informatics involves the use of information technology in healthcare, which is essential for managing patient data and improving communication. However, while informatics supports various aspects of patient care, it is not the primary concern during the perioperative period. The focus during this time is on ensuring the client's immediate well-being and preventing harm.

Choice B reason:
Quality improvement is a continuous process of identifying and implementing changes to improve patient care and outcomes. While it is a critical component of nursing practice, the priority in the perioperative period is the safety of the client, which is a more immediate concern.

Choice C reason:
Safety is the most critical QSEN competency during the perioperative period. This period involves significant risks due to anesthesia, surgical procedures, and potential complications. Ensuring the client's safety by preventing errors, reducing the risk of harm, and maintaining a sterile environment is paramount.

Choice D reason:
Evidence-based practice involves using the best current evidence to make informed decisions about patient care. While it is crucial for guiding clinical practice, the immediate priority in the perioperative period is ensuring the client's safety through vigilant monitoring and intervention.