A nurse is providing teaching to a client who has coronary artery disease. Which of the following statements should the nurse include in the teaching to explain the correlation between changes in the coronary arteries and manifestations that occur?

A. "Note if you see any flashing bright lights on the grid." Flashing lights are not typically associated with macular degeneration. This symptom is more commonly associated with conditions like retinal detachment or migraine headaches.

B. "Check to see if the lines on the grid are blurry or distorted." This statement is correct. The Amsler grid is used to detect changes in central vision, which are common in macular degeneration. Patients with macular degeneration may perceive wavy or distorted lines instead of straight lines when looking at the grid, indicating central vision loss.

C. "Monitor for the lines on the grid to change in color or brightness." Changes in color or brightness of the lines on the grid are not typical features of macular degeneration. This statement does not accurately reflect the purpose of using an Amsler grid for macular degeneration.

D. "Watch for floating dark spots on the grid." Floating dark spots (floaters) are not typically associated with macular degeneration. Floaters are more commonly associated with conditions like posterior vitreous detachment or retinal detachment.

A. Administer pain medication as needed. Rationale: Pain management is essential for clients with traumatic brain injury (TBI) to ensure their comfort and to prevent agitation or increased intracranial pressure (ICP) due to pain. Administering pain medication as needed helps alleviate discomfort and promotes rest, which supports the client's recovery.

B. Maintain ventriculostomy at the correct position. Rationale: Ventriculostomy, also known as an external ventricular drain (EVD), is a critical component of managing intracranial pressure (ICP) in clients with traumatic brain injury. Maintaining the ventriculostomy at the correct position ensures accurate monitoring and drainage of cerebrospinal fluid (CSF), which helps control ICP levels and prevents complications such as cerebral edema.

C. Maintain the neck in the midline position. Rationale: Keeping the neck in a midline position is essential for clients with traumatic brain injury to prevent further injury to the cervical spine. Proper alignment of the neck helps maintain spinal stability and reduces the risk of exacerbating any existing spinal cord injury, which may coexist with the traumatic brain injury.

D. Elevate the head of the bed to 30 degrees. Rationale: Elevating the head of the bed to 30 degrees is recommended for clients with traumatic brain injury to promote cerebral venous drainage and reduce intracranial pressure (ICP). This position helps optimize cerebral perfusion and minimizes the risk of cerebral edema, which can occur with increased ICP.

E. Maintain enteral feedings. Rationale: Nutritional support is crucial for clients with traumatic brain injury to support healing and recovery. Enteral feedings, such as tube feedings, may be necessary if the client is unable to consume adequate nutrition orally due to impaired swallowing or altered consciousness. Providing enteral feedings ensures the client receives essential nutrients to support tissue repair and prevent malnutrition-related complications during the recovery process.