One year after being discharged from the burn trauma unit, a client with a history of 40% full-thickness burns is admitted with bone pain and muscle weakness. Which intervention should the nurse include in this client's plan of care?

Choice A reason: Explaining the need for skin exposure to sunlight without sunscreen is not advisable because it can increase the risk of further skin damage or skin cancer, especially in a client with a history of severe burns. Sunscreen should be used to protect the skin from harmful UV rays.

Choice B reason: Teaching the need for dietary and supplemental vitamin D is important because clients with extensive burns often have impaired vitamin D synthesis due to reduced exposure to sunlight and possible nutritional deficiencies. Vitamin D is essential for bone health and muscle function.

Choice C reason: Instructing the client in the use of muscle strengthening exercises is beneficial for overall health, but it does not directly address the specific issue of bone pain and muscle weakness related to potential vitamin D deficiency.

Choice D reason: Encouraging progressive active range of motion is important for maintaining joint flexibility and function, but it does not directly address the underlying cause of bone pain and muscle weakness in this scenario.

Choice A reason: Recommending that the client's family return to the area to help provide assistance is not always feasible and may place undue stress on the family. It is also not a sustainable long-term solution.

Choice B reason: Advising a case management evaluation of the client's home environment is the best response as it allows for a comprehensive assessment of the client's needs and resources. The case manager can help coordinate care, arrange for necessary services, and provide support for both the client and her husband.

Choice C reason: Suggesting contacting social services to help find a respite care facility for her husband is a reasonable option, but it may not be the most immediate or suitable solution for the client’s concerns. This option should be considered as part of the overall case management plan.

Choice D reason: Telling her to consider hiring a private nurse during the postoperative convalescence may be helpful, but it can be costly and may not be necessary if other support systems are in place. It should be discussed as part of the case management evaluation.