A nurse is teaching a client who has fibromyalgia about self-care strategies for managing the disorder. Which of the following information should the nurse include in the teaching?

Choice A reason : Achieving a blood pressure of 120/80 is a general goal for overall cardiovascular health, but it is not specific to the management of heart failure. While controlling blood pressure is important in heart failure, the primary objective is to reduce the heart's workload¹.

Choice B reason : Reducing the workload on the heart is a key objective in managing heart failure. This can be achieved through medications that improve heart function, lifestyle changes, and sometimes surgical interventions. The goal is to improve the heart's efficiency and reduce symptoms such as shortness of breath and fatigue¹.

Choice C reason : Encouraging the client to walk briskly on a treadmill at 4 to 5 miles an hour may not be appropriate for all heart failure patients, especially without medical supervision. Exercise recommendations should be personalized based on the individual's condition and tolerance¹.

Choice D reason : While dietary modifications are part of heart failure management, completely eliminating all sodium and fat is not practical or recommended. Instead, a balanced diet with controlled sodium intake is advised to help manage fluid retention¹.

Choice A reason : Conducting 15-minute checks can be part of the safety measures for a client at risk of self-harm, but it may not be sufficient for someone who is actively hearing voices commanding self-harm and refusing to engage in safety planning. These checks are less intensive and may not provide the immediate intervention needed to ensure the client's safety¹.

Choice B reason : Encouraging the client to express feelings related to suicide is an important therapeutic intervention that can provide insight into the client's emotional state and risk factors. However, if the client is actively psychotic and not engaging in safety planning, this approach alone may not be enough to ensure immediate safety¹.

Choice C reason : Placing the client on one-to-one observation is the most direct and immediate intervention to ensure safety when a client is experiencing psychotic features and is at risk of self-harm. This level of observation means that the client is never alone, and a staff member is always present to intervene if the client attempts self-harm¹.

Choice D reason : Obtaining an order for locked seclusion can be considered if other less restrictive measures are not sufficient to ensure the client's safety. However, it is generally a last resort due to the potential for negative psychological effects and should only be used when absolutely necessary and when other interventions have failed¹.