An adult female patient is prescribed a 10-day course of nitrofurantoin (Macrodantin) to treat a urinary tract infection (UTI). On day 6, she calls the provider’s office and tells the nurse that her symptoms have resolved. She asks if she should continue the course of treatment.
What is the most appropriate response by the nurse?

Choice A rationale:
Planning is conducted during the initial stage of Lewin's change model, known as the unfreezing phase. This phase involves creating awareness of the need for change, building support, and developing a plan for implementation. It's not part of the refreezing phase.
Choice B rationale:
Change is initiated during the second stage of Lewin's change model, known as the change or transition phase. This phase involves implementing the planned changes, providing training and support, and addressing resistance. It's not part of the refreezing phase.
Choice C rationale:
The need for change is recognized during the unfreezing phase, not the refreezing phase. Recognizing the need for change is a crucial step in initiating the change process, but it's not the focus of the refreezing phase.
Choice D rationale:
Change becomes permanent during the refreezing phase. It involves solidifying the new behaviors and practices that have been implemented during the change phase. This is achieved through various strategies, such as:
Reinforcement of the new behaviors through rewards, recognition, and positive feedback
Integration of the new behaviors into organizational policies, procedures, and structures
Creation of a supportive culture that encourages and sustains the change
Ongoing monitoring and evaluation to ensure that the change is sustained over time

Rationale for Choice A:
Sims' position is a side-lying position with the lower arm and leg flexed and the upper arm and leg extended. It is not ideal for bladder scanning because it can displace the bladder and potentially lead to inaccurate readings. While it can be used for other purposes, such as inserting rectal suppositories or performing vaginal exams, it's not the optimal choice for bladder scanning.
Rationale for Choice B:
Dorsal recumbent position is a supine position with the knees bent and feet flat on the bed. While it provides some exposure of the bladder, it may not fully visualize the entire bladder due to potential compression from the abdominal contents. This can also result in inaccurate readings.
Rationale for Choice D:
High Fowler's position is a semi-sitting position with the head of the bed elevated at a 45- to 60-degree angle. This position is not suitable for bladder scanning because it can cause the bladder to shift upward and out of the optimal scanning range. It's typically used for respiratory comfort and procedures involving the head and upper body.
Rationale for Choice C:
Supine position is the best position for bladder scanning because it allows for the most accurate visualization of the bladder. In this position, the patient lies flat on their back with their legs extended. This position allows the bladder to rest naturally in the pelvic cavity, ensuring optimal positioning for the bladder scanner to capture a clear image and provide an accurate measurement of bladder volume. It also promotes patient comfort and relaxation during the procedure.