The client has protective precautions (reverse isolation) in place due to a severely depressed neutrophil count. Which statement by the client demonstrates a good understanding of the precautions?

• Client's hearing deficit: The client’s hearing loss poses a significant barrier to effective communication. Without a hearing aid, the client may have difficulty understanding verbal communication, leading to misunderstandings.

• Volume of the client's television: A loud television creates distracting background noise, making it challenging for the nurse to communicate clearly. This can hinder the client's ability to hear and comprehend important information during interactions.

• Numerous visitors in the client's room: Having multiple visitors can create distractions and noise, making it difficult for the nurse to effectively communicate with the client. Visitors may also divert the client’s attention, impacting their ability to engage in discussions with the nurse.

• Increase in pain after ambulation: The reported increase in pain can affect the client’s focus and engagement in communication. When experiencing pain, the client may find it challenging to concentrate on conversations, which impacts the overall effectiveness of communication with the nurse.

• Adverse effects of opioid analgesic: While not explicitly mentioned in the initial scenario, opioid analgesics can cause side effects such as sedation and confusion, which may impair the client’s ability to communicate effectively. This could lead to misunderstandings and miscommunication.

• Using earphones while listening to music: This factor, if present, would create a barrier to communication, as it would prevent the client from hearing the nurse's questions or instructions. However, it was not explicitly stated in the scenario.

A. Instruct the patient to cough and deep breathe to prevent atelectasis: While coughing and deep breathing are important post-operative interventions to prevent respiratory complications, they are not appropriate actions in the case of wound dehiscence. Encouraging coughing could exacerbate the situation by increasing intra-abdominal pressure.

B. Apply a sterile saline dressing and notify the surgeon immediately: This is the most appropriate immediate action in the event of wound dehiscence. Applying a sterile saline dressing helps protect the exposed tissue and prevent infection, while notifying the surgeon is crucial for further evaluation and intervention. Wound dehiscence is a surgical emergency that requires prompt attention.

C. Increase the patient's oral fluid intake to promote healing: While adequate hydration is important for overall recovery, it is not an immediate action to take in response to wound dehiscence. Addressing the wound itself and notifying the surgical team is the priority in this situation.

D. Apply pressure to the wound to stop any bleeding: While it is important to control bleeding, applying pressure may not be appropriate if there is significant opening or exposure of the internal structures. Instead, the focus should be on covering the wound with a sterile dressing and seeking immediate surgical intervention to assess and manage the dehiscence.