A nurse is providing discharge teaching to a client who will be receiving total parenteral nutrition (TPN) at home.
Which of the following instructions should the nurse include? (Select all that apply.)

Choice A rationale

Taking nitroglycerin when experiencing chest pain is correct as it helps to relieve the pain by dilating blood vessels and increasing blood flow to the heart.

Choice B rationale

Calling 911 if chest pain does not improve after taking nitroglycerin is correct and necessary to seek immediate medical assistance.

Choice C rationale

Storing nitroglycerin tablets in a dark, cool place is correct to maintain their potency, as light and heat can degrade the medication.

Choice D rationale

Taking up to three doses of nitroglycerin five minutes apart is correct; however, if the pain persists after one dose, the patient should call 911 immediately rather than waiting for all three doses to be taken.

Choice A rationale

Having the patient lift their back and buttocks using a trapeze allows for proper assessment of pressure areas and skin care. This technique reduces the risk of further injury or discomfort and provides better access for the nurse to assess the skin condition.

Choice B rationale

Asking the patient to turn to the side independently may not be feasible for a patient with a pelvic fracture. This method can cause pain and risk further injury, making it an unsuitable choice for assessing pressure areas.

Choice C rationale

Rolling the patient over to the side by pushing on the patient's hip is not recommended as it can exacerbate the injury and cause pain. This method is not appropriate for patients with pelvic fractures.

Choice D rationale

Deferring back assessment until the patient is ambulatory is not a safe practice. Pressure areas should be regularly assessed to prevent skin breakdown and complications, even if the patient is not yet ambulatory.