A patient is beginning treatment for pain with a transcutaneous electrical nerve stimulator (TENS) unit.
The nurse will initially:.

Choice A rationale:
IM injections of pain medication may be contraindicated for patients who have small, poorly developed muscles. The rationale for this is that IM injections require adequate muscle mass to ensure proper absorption and distribution of the medication. If a patient has small, poorly developed muscles, the injection may not be as effective, and there's a risk of improper medication delivery, which can lead to reduced pain relief and potential complications.
Choice B rationale:
IM injections are not primarily contraindicated for patients based on their cognitive abilities. However, the patient's cognitive abilities may affect their ability to understand and follow instructions related to the injection process. It's essential for healthcare providers to ensure that the patient comprehends the procedure and can cooperate. Patients with cognitive impairments may require additional assistance or alternative methods of pain management, but it's not a direct contraindication to IM injections.
Choice C rationale:
Needing short-term pain management is not a contraindication for IM injections of pain medication. IM injections can be suitable for short-term pain relief, as they can provide relatively rapid and effective pain control. The choice of pain management method should depend on the specific circumstances and the patient's condition, but the duration of pain management needed is not a direct contraindication to IM injections.
Choice D rationale:
Having multiple drug allergies can be a concern when considering IM injections of pain medication, but it is not a direct contraindication. The healthcare provider should carefully assess the patient's allergies and select a medication that is safe and appropriate for the individual. In some cases, alternative routes of administration may be considered to avoid allergenic reactions. However, having multiple drug allergies alone does not necessarily contraindicate IM injections.

Choice A rationale:

Taking a warm bath before trying to go back to sleep is a relaxation technique that may help with sleep but does not address the underlying causes of insomnia. It is more of a short-term coping strategy rather than a method for locating the reasons for the insomnia.

Choice B rationale:

Reviewing times in her life when she had no insomnia is not a practical approach to addressing the current issue of insomnia. It does not help in identifying the specific factors or triggers contributing to the patient's current sleep problems.

Choice C rationale:

Keeping a diary related to sleep and problems encountered is a practical and effective approach to identify the factors contributing to the patient's insomnia. This diary can help track patterns, such as bedtime routines, diet, stressors, and other variables that may be linked to the sleep problem. Identifying these factors can aid in developing a plan to address the specific causes of the insomnia.

Choice D rationale:

Discussing the problem with her friends may provide emotional support but is unlikely to help identify the root causes of the insomnia. Friends may offer advice or share their experiences, but a structured approach like keeping a sleep diary is more likely to yield valuable information.