A nurse is providing discharge teaching to a client who is 1 day postoperative following a right modified radical mastectomy. Which of the following instructions should the nurse include in the teaching?

A. "Think about a positive outcome to a stressful situation." - This instruction describes a cognitive restructuring technique, which involves reframing negative thoughts with positive ones. While cognitive restructuring can be helpful for managing stress and anxiety, it is not specifically related to progressive relaxation.
B. "Tighten a muscle group, then release the tension and move to the next one." - This is the correct instruction for progressive relaxation. Progressive relaxation involves systematically tensing and relaxing muscle groups throughout the body to reduce physical tension and promote relaxation. By sequentially tensing and releasing muscle groups, the client learns to recognize and control muscle tension, which can help alleviate stress and anxiety.
C. "Focus on a pleasant memory and express your emotions in writing." - This instruction describes a journaling or expressive writing technique, which can be beneficial for processing emotions and reducing stress. However, it is not specific to progressive relaxation.
D. "Picture taking the stress you feel and pushing it down and out of your feet." - This instruction describes a visualization or imagery technique, where the client visualizes releasing stress from the body. While visualization can be a component of relaxation exercises, it is not specifically associated with progressive relaxation, which focuses on muscle tension and relaxation.

A. Occupational therapist: While occupational therapy may be beneficial for some aspects of managing sciatica, such as ergonomic assessments and activities of daily living modifications, a referral to an occupational therapist is not typically indicated specifically for the use of a TENS unit.
B. Chiropractor: Chiropractic care involves manual adjustments of the spine and other joints, which may provide relief for some individuals with sciatica. However, a referral to a chiropractor is not necessary solely for the use of a TENS unit.
C. Acupuncturist: Acupuncture is a complementary therapy that involves the insertion of thin needles into specific points on the body to relieve pain and promote healing. While acupuncture may be considered as part of a comprehensive treatment plan for sciatica, it is not typically associated with the use of a TENS unit.
D. Physical therapist: Physical therapy plays a crucial role in the management of sciatica. A physical therapist can provide tailored exercises, stretches, and modalities such as TENS therapy to alleviate pain, improve mobility, and strengthen muscles. Therefore, a referral to a physical therapist is appropriate for a client with sciatica who has a prescription for a TENS unit. The physical therapist can assess the client's condition, educate them on the proper use of the TENS unit, and integrate it into their overall treatment plan.