A nurse is providing emotional support to a client who is anxious about an upcoming surgery. Which of the following statements by the nurse demonstrates the use of evidence-based practice and clinical judgment?

Choice A reason:

Reviewing the plan of care and the prescribed treatment is the first step in the nursing process for a direct care intervention. The nurse needs to know what the goals, outcomes, and interventions are for the client before performing any action. This ensures that the nurse is following the evidence-based practice and the client's preferences. Reviewing the plan of care also helps the nurse to identify any changes or updates that might be needed based on the client's current condition.

Choice B reason:

Applying sterile gloves and cleaning the wound with saline is an important intervention for a client who has a wound infection, but it is not the first step. The nurse needs to review the plan of care and the prescribed treatment before performing any procedure to ensure that it is appropriate, safe, and effective for the client. Cleaning the wound with saline is part of the implementation phase of the nursing process, which comes after assessment, diagnosis, and planning.

Choice C reason:

Teaching the client about wound care and infection prevention is another important intervention for a client who has a wound infection, but it is not the first step either. The nurse needs to review the plan of care and the prescribed treatment before providing any education to the client. Teaching the client is also part of the implementation phase of the nursing process, which comes after assessment, diagnosis, and planning.

Choice D reason:

Documenting the wound appearance and drainage is a vital component of nursing care, but it is not the first step in a direct care intervention. The nurse needs to review the plan of care and the prescribed treatment before documenting any findings or actions. Documenting the wound appearance and drainage is part of the evaluation phase of the nursing process, which comes after assessment, diagnosis, planning, and implementation.

Choice A reason:

This statement by the nurse suggests a possible intervention for the client's anxiety, but it does not demonstrate the use of evidence-based practice or clinical judgment. Evidence-based practice involves using the best available research evidence, clinical expertise, and patient preferences to make decisions about care. Clinical judgment involves applying critical thinking, knowledge, skills, and experience to assess, plan, implement, and evaluate outcomes of care. The nurse should first assess the client's level of anxiety, sources of anxiety, and coping strategies before suggesting any relaxation techniques. The nurse should also consider the client's values and expectations when choosing an intervention.

Choice B reason:

This statement by the nurse is an example of false reassurance and self-disclosure, which are not appropriate or therapeutic communication techniques. The nurse should avoid saying "I know how you feel”. because it minimizes the client's feelings and assumes that the nurse's experience is similar to the client's. The nurse should also avoid sharing personal information unless it is relevant and beneficial for the client. The nurse should focus on the client's feelings and concerns rather than their own.

Choice C reason:

This statement by the nurse is another example of false reassurance, which is not helpful or evidence-based. The nurse should avoid saying "Don't worry”. or "Everything will be fine”. because it dismisses the client's feelings and implies that the client has no reason to be anxious. The nurse should also avoid giving opinions or guarantees about the outcome of the surgery, as they are not based on facts or evidence. The nurse should acknowledge the client's anxiety and provide factual information about the surgery and the care team.

Choice D reason:

This statement by the nurse demonstrates the use of evidence-based practice and clinical judgment. The nurse is using an open-ended question to elicit the client's main concerns about the surgery, which shows respect and empathy for the client's feelings. The nurse is also using clinical judgment to assess the client's level of anxiety and knowledge deficit. The nurse is planning to provide information that might help reduce the client's anxiety.