The practical nurse (PN) determines that a client's pupils constrict as they change focus from a far object to a near object. How should the PN document this finding?

d) Notify the charge nurse of the client's concerns about surgery.

Explanation:

When a client expresses fear and uncertainty about undergoing surgery, it is important for the practical nurse (PN) to communicate this information to the charge nurse or the healthcare provider. By notifying the appropriate person, the PN ensures that the client's concerns are addressed and appropriate interventions can be implemented.

Options a) and c) are not the priority actions because documenting the client's concerns or reminding them about the signed consent does not address their emotional needs or provide support.

Option b) may not be the most appropriate response, as simply encouraging the client to continue with the scheduled surgery without addressing their fears and uncertainties may not be sufficient to alleviate their anxiety.

Therefore, the best course of action is to notify the charge nurse or healthcare provider so that they can assess the client's concerns, provide reassurance, and address any questions or fears the client may have prior to the surgery.

Choice A reason: Decreasing bright lights is not the first action that the nurse should perform because it does not address the priority problem of potential infection and inflammation of the meninges, which can cause serious complications such as brain damage or deatH. Decreasing bright lights can help reduce photophobia and headache, but it is not an urgent intervention.

Choice B reason: Initiating IV access is not the first action that the nurse should perform because it does not address the priority problem of potential infection and inflammation of the meninges, which can cause serious complications such as brain damage or deatH. Initiating IV access can facilitate fluid and medication administration, but it is not an immediate intervention.

Choice C reason: Administering antibiotics is not the first action that the nurse should perform because it requires a physician's order and confirmation of the diagnosis and causative organism by laboratory tests such as blood culture or cerebrospinal fluid (CSF) analysis. Administering antibiotics can treat bacterial meningitis, but it is not a priority intervention.

Choice D reason: Implementing droplet precautions is the first action that the nurse should perform because it addresses the priority problem of potential infection and inflammation of the meninges, which can cause serious complications such as brain damage or deatH. Implementing droplet precautions can prevent transmission of meningitis to other clients or staff, as meningitis can be spread by respiratory droplets from coughing, sneezing, or talkinG.