A young woman has been in an automobile crash that resulted in an amputation of her left lower leg. She verbalizes grief and loss.
What cognitive knowledge by the registered nurse is used to provide interventions to help the client cope?

Choice A rationale:
It is inappropriate and dismissive to tell a client who has experienced a traumatic loss that they should be grateful to be alive. This statement invalidates the client's feelings of grief and loss, and it can hinder the coping process.
It is important for nurses to recognize that grief is a normal and healthy response to loss.
Telling a client to be grateful can imply that their feelings of grief are not valid or that they are not coping appropriately. This can lead to feelings of guilt, shame, and isolation, which can further complicate the grieving process.
Choice B rationale:
It is incorrect to label a client's grief as an abnormal or inappropriate response. Grief is a universal human experience, and there is no right or wrong way to grieve.
Each individual grieves in their own way and at their own pace.
Some people may express their grief openly, while others may grieve more privately.
It is important for nurses to respect the client's individual grieving process and to provide support without judgment. Choice C rationale:
It is important for nurses to recognize that grief is a normal and healthy response to loss.
It is a natural process that allows individuals to come to terms with their loss and to adjust to life without their loved one or without a part of their body.
Experiencing grief does not mean that there is something wrong with the client.
In fact, it is a sign that the client is beginning to process their loss.
Choice D rationale:
While tissue healing is important, it is not the only factor that will help the client to adapt to their loss. The client will also need to address the emotional and psychological aspects of their loss.
This may involve talking about their feelings, seeking support from others, and finding ways to cope with their grief.

Choice A rationale:
Reduced kidney ability to concentrate urine is a common physiological change associated with normal aging. This is due to several factors, including:

Decreased glomerular filtration rate (GFR): The kidneys filter waste products from the blood. As we age, the number of functioning nephrons (filtering units) in the kidneys decreases, leading to a decline in GFR. This means that the kidneys are less able to filter waste products and concentrate urine.
Decreased renal blood flow: Blood flow to the kidneys also decreases with age. This further reduces the kidneys' ability to filter waste products and concentrate urine.
Decreased tubular function: The tubules in the kidneys are responsible for reabsorbing water and electrolytes from the urine. As we age, the function of the tubules also declines, leading to a decrease in the ability to concentrate urine.
As a result of these changes, older adults often produce more urine, even at night. This can lead to nocturia, which is the need to wake up to urinate two or more times per night.
Choice B rationale:
Lower fluid intake during daytime hours can also contribute to nocturia, but it is not a direct physiological change associated with normal aging. Older adults may drink less fluids during the day for a variety of reasons, such as decreased thirst sensation, fear of incontinence, or limited access to fluids. However, even if they maintain adequate fluid intake during the day, they may still experience nocturia due to the reduced ability of their kidneys to concentrate urine.
Choice C rationale:
Enhanced bladder contractility leading to urinary stasis is not a typical physiological change associated with normal aging. In fact, bladder contractility often decreases with age, which can lead to difficulty emptying the bladder completely. This can contribute to urinary frequency and urgency, but it is not typically a cause of nocturia.
Choice D rationale:
Increased bladder muscle tone leading to frequent urination is also not a typical physiological change associated with normal aging. Bladder muscle tone may decrease with age, which can lead to difficulty emptying the bladder completely. However, it is not typically a cause of nocturia.