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: There is no specific requirement to avoid upper body exercise on the day of a mammogram. While vigorous exercise might cause some temporary muscle discomfort, it does not impact the results of the mammogram. The primary concern is ensuring clear imaging of the breast tissue, not the effects of exercise.
Choice B reason: Clients are instructed not to use underarm deodorant on the day of a mammogram because deodorants, antiperspirants, powders, or lotions can contain metallic particles that may appear on the mammogram images as white spots. These spots can be mistaken for calcifications, leading to potential misinterpretation of the results or the need for additional imaging. Ensuring the client avoids using these products helps achieve the clearest possible images for accurate diagnosis.
Choice C reason: Avoiding aspirin for one week prior to a mammogram is not a standard instruction. Aspirin can affect blood clotting, and such instructions are typically given before surgical procedures rather than imaging tests. There is no direct impact of aspirin on the mammogram process or results.
Choice D reason: There is no requirement to avoid eating or drinking for 6 hours before a mammogram. This instruction is more relevant for procedures that involve anesthesia or sedation, where an empty stomach is necessary to reduce the risk of aspiration. Mammograms do not involve these risks, and clients can eat and drink as usual.

Choice A reason: Evaluating neuro vital signs includes assessing the client's level of consciousness, pupil response, motor function, and other neurological indicators. While important for overall assessment, changes in neurological status are not the most immediate concern in the context of heart failure and the client's request for more pillows. The request may be related to orthopnea, a common symptom of heart failure where clients experience difficulty breathing while lying flat.
Choice B reason: Monitoring urinary output is crucial for assessing kidney function and fluid balance, especially in clients with heart failure. However, it does not directly address the client's symptom of needing more pillows to sleep, which is more likely related to respiratory discomfort. While maintaining adequate urinary output is important, it is not the primary assessment needed in this scenario.
Choice C reason: Blood pressure is a vital sign that needs regular monitoring in clients with heart failure, as it can indicate fluid status and cardiac function. However, the need for additional pillows to sleep is more directly related to respiratory issues rather than blood pressure alone. While important, it is not the primary focus in response to the client's specific request.
Choice D reason: Evaluating breath sounds is the most relevant assessment when a client with heart failure requests more pillows to sleep. This request often indicates orthopnea, where the client has difficulty breathing while lying flat due to fluid accumulation in the lungs (pulmonary congestion). By assessing breath sounds, the PN can detect signs of crackles, wheezing, or decreased air entry, which may indicate worsening heart failure or pulmonary edema. Prompt assessment and intervention are crucial to address respiratory distress and prevent further complications.