A nurse is speaking with the caregiver of a client who has Alzheimer’s disease. The caregiver states, “Providing constant care is very stressful and is affecting all areas of my life.” Which of the following actions should the nurse take?

Choice A reason: Supine positioning risks respiratory strain post-myocardial infarction; semi-Fowler’s is preferred. Cardiac rehabilitation is appropriate. Assuming supine is correct risks discomfort or complications, critical to avoid in ensuring proper positioning and recovery support for clients 3 days post-acute myocardial infarction.

Choice B reason: ECG every 12 hours is excessive 3 days post-myocardial infarction unless symptomatic; daily or as-needed is standard. Rehabilitation consultation is key. Assuming frequent ECGs risks unnecessary testing, critical to prevent in focusing on recovery planning and rehabilitation for post-infarction clients.

Choice C reason: Troponin levels every 4 hours are unnecessary 3 days post-myocardial infarction, as levels peak earlier; rehabilitation is priority. Assuming frequent troponin checks risks redundant testing, critical to avoid in ensuring appropriate care focus on recovery and rehabilitation post-acute myocardial infarction.

Choice D reason: Obtaining a cardiac rehabilitation consultation 3 days post-myocardial infarction supports recovery through structured exercise and education, critical for preventing further events. This intervention promotes long-term cardiac health, essential for reducing readmissions, enhancing recovery, and improving quality of life in post-infarction clients.

Choice A reason: Asking why the client wants notes may seem dismissive, not addressing legal rights; stating notes are excluded is correct. Assuming curiosity is the focus risks alienating the client, critical to avoid in ensuring respectful, compliant handling of medical record requests in psychotherapy.

Choice B reason: Stating no benefit from notes is judgmental, not addressing legal access; notes are typically excluded from records. Assuming benefit assessment is appropriate risks undermining autonomy, critical to prevent in ensuring ethical, client-centered responses to psychotherapy record requests in mental health care.

Choice C reason: Therapist’s notes are often excluded from releasable records under HIPAA, as they are personal process notes. This response is legally accurate, critical for compliance, ensuring client rights to records while protecting therapeutic notes, supporting ethical practice in mental health clinic settings.

Choice D reason: Asking about treatment satisfaction deflects from the records request; stating notes are excluded is accurate. Assuming dissatisfaction is the issue risks miscommunication, potentially reducing trust, critical to avoid in ensuring clear, compliant responses to client requests for psychotherapy notes.