The nurse is assessing the patient’s respirations. Which action by the nurse is most appropriate?

Choice A reason: This response dismisses the patient’s anxiety by offering superficial reassurance without addressing their emotional state. Preoperative anxiety activates the sympathetic nervous system, increasing cortisol and adrenaline, which disrupt sleep by elevating heart rate and alertness. This approach fails to validate emotions, potentially worsening stress responses and hindering psychological coping, making it non-therapeutic for addressing the patient’s distress.

Choice B reason: Questioning the patient’s insomnia and implying they should feel reassured invalidates their feelings. Anxiety triggers the hypothalamic-pituitary-adrenal axis, releasing stress hormones that disrupt REM sleep cycles. This response lacks empathy, failing to address the limbic system’s role in emotional distress, which is critical for therapeutic communication to reduce preoperative anxiety and promote emotional stability.

Choice C reason: Minimizing the patient’s concerns and focusing on pharmacological intervention ignores emotional needs. Sedatives may depress the central nervous system to induce sleep, but they don’t address anxiety-driven amygdala activation, which elevates cortisol. A therapeutic response should validate feelings and offer emotional support to mitigate stress responses, making this option inadequate for addressing the patient’s psychological state.

Choice D reason: This empathetic response acknowledges the patient’s uncertainty and invites dialogue, aligning with therapeutic communication principles. Preoperative anxiety, driven by fear of unknown surgical outcomes, activates the limbic system, increasing heart rate and cortisol. By validating emotions and offering support, this response fosters trust, reduces stress hormone release, and supports psychological coping, making it the most appropriate choice.

Choice A reason: Urinary status, such as output, monitors hydration and kidney function post-surgery but is unrelated to safe oral intake. Abdominal surgery risks paralytic ileus, where intestinal motility ceases, increasing aspiration risk if food is consumed. Bowel sounds indicate gastrointestinal function recovery, making urinary status a secondary consideration for dietary decisions.

Choice B reason: Skin turgor assesses hydration but does not determine readiness for oral intake post-surgery. Abdominal surgery can impair peristalsis, causing ileus, which risks vomiting or obstruction if food is introduced prematurely. Assessing bowel sounds confirms intestinal motility, critical for safe eating, while skin turgor is irrelevant to gastrointestinal recovery.

Choice C reason: Pain level is important for patient comfort but not the primary consideration for eating post-surgery. Pain may indicate complications, but absent bowel sounds suggest ileus, a condition where the gut lacks motility, risking aspiration. Bowel sounds confirm peristalsis, ensuring safe digestion, making pain a secondary factor in this context.

Choice D reason: Bowel sounds indicate gastrointestinal motility, critical after abdominal surgery to prevent complications like ileus. Absent sounds suggest impaired peristalsis, increasing risks of vomiting or obstruction if food is consumed. Auscultating active bowel sounds confirms the gut’s readiness to process food, making this the primary consideration before allowing eating to ensure safety.