The practical nurse (PN) is assisting a client who is performing peritoneal dialysis catheter self-care before being discharged home. Which behavior indicates that the client needs additional teaching?

Choice A reason: Suction equipment is essential for a client who has undergone fixation of a mandible fracture. Due to the nature of the surgery and the presence of wiring, the client may have difficulty managing oral secretions. Suction equipment ensures that any secretions can be promptly and effectively removed, preventing aspiration and maintaining a clear airway. This equipment is vital for managing the client's immediate postoperative needs and ensuring their safety.
Choice B reason: A crash cart, while critical in emergency situations, is not specifically required to be present in the client's room following mandible fracture fixation. Crash carts are typically available on the unit and can be quickly brought to the room if needed. The practical nurse should be familiar with the location of the crash cart and how to access it, but it does not need to be permanently stationed in the client's room.
Choice C reason: A non-rebreather mask is used to deliver high concentrations of oxygen to clients experiencing severe respiratory distress or hypoxemia. While it is an important piece of equipment for respiratory emergencies, it is not specifically necessary to have in the room of a client with a mandible fracture fixation. The priority is to have suction equipment and wire cutters immediately available, while other oxygen delivery devices can be accessed as needed.
Choice D reason: A nasogastric tube is used for decompression of the stomach or for feeding clients who are unable to take oral nutrition. It is not specifically required for a client with a mandible fracture fixation unless there are additional complications or indications for its use. The practical nurse should focus on equipment directly related to managing the fixation and maintaining the client's airway.
Choice E reason: Wire cutters are a critical item to have in the room of a client with a mandible fracture fixation. In the event of an emergency, such as vomiting or respiratory distress, the wires securing the mandible may need to be quickly cut to ensure the client's airway is not compromised. Having wire cutters immediately available ensures that the practical nurse can respond swiftly and effectively to any urgent situations, maintaining the client's safety and airway patency.

Choice A reason: Impaired communication can be a concern for clients with Guillain-Barré syndrome (GBS), especially if they experience facial weakness or difficulty speaking. This can impact their ability to express needs and interact with caregivers, potentially leading to frustration and miscommunication. Although it's important to address communication issues, it is not the highest priority compared to the risk of respiratory compromise due to ascending paralysis, which can be life-threatening.
Choice B reason: Ascending paralysis is the most critical problem to address in clients with GBS. This condition can lead to progressive muscle weakness that starts in the lower extremities and moves upward, potentially affecting the respiratory muscles. Respiratory failure is a life-threatening complication of GBS, and monitoring for signs of ascending paralysis is essential to ensure timely intervention and support, such as mechanical ventilation if needed. Early detection and management of ascending paralysis can significantly impact the client's prognosis and overall outcome.
Choice C reason: Fear and anxiety are common in clients with GBS due to the sudden onset and potential severity of the condition. While addressing emotional well-being is important, it is not the highest priority compared to the risk of respiratory compromise. Providing emotional support and reassurance can help alleviate anxiety and improve the client's overall experience. However, the primary focus should be on monitoring and managing physical symptoms, particularly those that pose an immediate threat to the client's life.
Choice D reason: Immobility can result from muscle weakness and paralysis in clients with GBS. Prolonged immobility can lead to complications such as pressure ulcers, deep vein thrombosis (DVT), and muscle atrophy. While it is important to prevent and manage these complications through interventions like physical therapy and repositioning, the immediate priority is to monitor for ascending paralysis and ensure adequate respiratory function. Once the client's respiratory status is stable, comprehensive care can include addressing immobility-related issues.