An older adult patient experiences a fracture of the lower leg and undergoes closed reduction and placement of a fiberglass cast. What should the nurse prepare for when planning care?

Choice A reason: This statement is incorrect because it suggests that higher oxygen levels trigger breathing, which is not the case in hypoxic drive.

Choice B reason: While carbon dioxide levels do influence breathing, this statement is not accurate in the context of hypoxic drive, which is specifically about oxygen levels.

Choice C reason: This choice is incorrect because the client does notice the need to breathe, but the trigger is low oxygen rather than high carbon dioxide levels.

Choice D reason: This is correct. In clients with COPD, chronic high levels of carbon dioxide can lead to a reliance on low oxygen levels to stimulate breathing.

Choice A: "I’m sorry if I upset you. I just wanted to make sure you’re aware of the day’s schedule."

This response may seem empathetic, but it could potentially reinforce the client's aggressive behavior. The nurse is apologizing, which might give the impression that the client's rude behavior is acceptable¹.

Choice B: "Well, if you can read it yourself, then why don’t you?"

This response is confrontational and could escalate the situation. It's important for the nurse to maintain a neutral and respectful manner.

Choice C: "You don’t have to be so rude. I’m just doing my job."

This response is defensive and could provoke further aggression from the client. It's not recommended to respond defensively to clients with borderline personality disorder¹.

Choice D: "I didn’t mean to offend you. I’ll leave the schedule here for you to review."

This is the most appropriate response. The nurse acknowledges the client's feelings without reinforcing the aggressive behavior. The nurse also respects the client's autonomy by leaving the schedule for the client to review¹.