A nurse is teaching a client who has a new diagnosis of gastroesophageal reflux disease. Which of the following instructions should the nurse include?

Rationale:
A. Contact the provider who will be performing the procedure: It is the provider’s legal and ethical responsibility to explain the procedure, including its purpose, risks, benefits, and alternatives. If the client does not understand, the nurse must contact the provider to clarify and ensure informed consent is valid.

B. Instruct the client's spouse to sign the consent form: A spouse may only sign the form if the client is legally unable to do so. If the client is competent but lacks understanding, they should not sign until they receive adequate information from the provider.

C. Read the consent form to the client using words the client will understand: While the nurse can clarify terms, reading or paraphrasing the consent form does not replace the provider’s obligation to explain the procedure fully and answer questions.

D. Provide teaching about the surgical procedure for the client: Nurses may reinforce information, but only the provider can give the detailed explanation required for informed consent. Providing full procedural teaching falls outside the nurse’s scope for consent purposes.

Rationale:

A. "I understand that I need to inspect my feet daily."Daily foot inspection is essential for individuals with diabetes to identify any cuts, blisters, or signs of infection early. Reduced sensation due to peripheral neuropathy can lead to unnoticed injuries that progress to serious complications if untreated.
B. "I will dry my feet thoroughly when I get out of the shower." Keeping the feet dry, especially between the toes, helps prevent fungal infections and skin breakdown. Moist environments encourage fungal growth, which can worsen foot health in diabetic clients.
C. "It is important to apply lotion to my feet and especially my toes to keep my skin in good health." While moisturizing helps prevent dry, cracked skin, lotion should not be applied between the toes. Moisture trapped between the toes increases the risk of fungal infections and skin maceration in diabetic clients.
D. "I will be very careful when I cut my toenails and will be sure to cut them straight across and then file the edges with an emery board." Cutting toenails straight across and filing the edges helps prevent ingrown toenails and reduces the risk of accidental skin injury. Diabetic clients are advised to be cautious during nail care due to impaired healing and infection risk.
E. "I will wear closed toed shoes." Wearing closed-toed shoes protects the feet from injury and trauma. Open-toed shoes or sandals may expose the feet to injury, and diabetic clients may not feel injuries due to neuropathy.
F. "I am glad I can still go barefoot in the house because I never wear shoes at home."Going barefoot, even indoors, increases the risk of stepping on sharp objects and sustaining unnoticed injuries. Clients with diabetes should always wear well-fitting shoes or protective footwear, even at home.
G. "If I have any foot sores or corns come up, I will see my doctor or go to a podiatrist instead of treating it myself." Diabetic clients should avoid self-treating foot problems like sores or corns. Prompt evaluation by a healthcare provider prevents complications like infections or ulcers, which can escalate quickly in this population.