A nurse is teaching a group of newly licensed nurses about client advocacy. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?

Rationale:

A. "You should not drink through a straw for 2 weeks.": Drinking through a straw can create pressure in the middle ear, which may dislodge the tympanic membrane graft or interfere with healing after a myringotomy. Avoiding straws is an important precaution to protect the surgical site and promote proper recovery.

B. "You should expect excessive ear drainage for about 48 hours": Some drainage may occur, but excessive drainage is not expected and could indicate infection or complications. Clients should be instructed to report any abnormal or persistent drainage to the provider rather than expecting it as normal.

C. "You can wash your hair 3 days after the procedure.": Hair washing is typically delayed until the provider confirms it is safe, usually after avoiding water in the ear for a few days. Premature washing could allow water to enter the middle ear, increasing the risk of infection.

D. "You should blow your nose with your mouth closed": Blowing the nose increases pressure in the middle ear and can compromise the healing of the tympanic membrane. Clients should be taught to avoid nose-blowing entirely or do so gently with the mouth open if necessary.

Rationale:

A. Sit at or below the client's eye level during feedings: Positioning the nurse at or slightly below the client’s eye level promotes effective communication and allows close observation of swallowing. It helps the nurse monitor for signs of aspiration, coughing, or choking, which is critical in clients with dysphagia to ensure safety during meals.

B. Instruct the client to lift her chin when swallowing: Clients with dysphagia should be taught to tuck the chin slightly toward the chest, not lift it, to protect the airway and facilitate safer swallowing. Lifting the chin increases the risk of aspiration and airway compromise.

C. Talk with the client during her feeding: Talking while swallowing increases the risk of aspiration because it distracts the client and can disrupt coordinated swallowing. Silence and focused attention are recommended during feeding to ensure safe intake of food and liquids.

D. Discourage the client from coughing during feedings: Coughing is a protective reflex that clears the airway if food or liquid enters the trachea. Discouraging it could increase the risk of aspiration and choking, making it unsafe to suppress this natural defense mechanism.