When instructing a client on using the three-point gait with crutches, which of the following steps should be emphasized to ensure correct usage and safety? (Select all that apply)

A. Encourage coughing and deep breathing: This technique helps mobilize secretions and improve lung expansion but does not directly thin secretions. It is supportive for airway clearance, yet hydration is more effective for thinning mucus consistency.

B. Encourage the client to increase fluid intake: Adequate hydration helps liquefy and thin respiratory secretions, making them easier to expectorate. Increased fluid intake is a primary intervention for promoting secretion clearance in clients with pneumonia.

C. Encourage regular use of the incentive spirometer: Incentive spirometry supports lung expansion and prevents atelectasis but does not significantly impact secretion viscosity. It is important for respiratory health but not the best measure for thinning mucus.

D. Encourage the client to ambulate frequently: Ambulation improves ventilation and circulation, which aids overall recovery. However, it does not directly thin respiratory secretions, though it can complement hydration in promoting airway clearance.

A. Ensuring the patient receives medication to alleviate anxiety before signing: Administering anxiolytics may help the patient feel calmer, but it does not ensure that the patient fully understands the procedure or voluntarily consents.

B. Witnessing the patient's signature and ensuring they understand the procedure: The nurse’s role in informed consent includes verifying that the patient comprehends the procedure, risks, benefits, and alternatives, and confirming that consent is given voluntarily. Witnessing the signature ensures that legal and ethical standards are met while supporting patient autonomy.

C. Providing detailed information about the risks and benefits of the procedure: While patient education is essential, providing detailed information is primarily the responsibility of the physician or provider performing the procedure.

D. Obtaining consent from the patient if they are unable to sign themselves: If a patient cannot sign due to physical limitations, a legally authorized representative may provide consent, or the patient may give verbal consent witnessed by the nurse.