When obtaining a fingerstick blood sugar, the practical nurse (PN) uses the lancet to prick the client's finger. After observing that a drop of blood is visible on the finger, which action should the PN take?

Choice A reason: Placing the food and utensils in the client's left visual field and leaving him alone does not address the underlying issue of the visual field deficit. While it may temporarily solve the problem of the client eating only the food on the left side, it does not encourage the client to adapt to or compensate for the right homonymous hemianopsia. The goal of rehabilitation is to help the client develop strategies to manage their condition independently, and this approach does not foster such skills.
Choice B reason: Feeding the client foods that are on the right side of his visual field is not the most effective approach, as it does not promote the client's independence or help them adapt to their visual field deficit. While it ensures the client consumes the food on the right side, it does not teach the client to compensate for their hemianopsia, which is an essential aspect of their rehabilitation.
Choice C reason: Reminding the client to look all over the tray to view and eat all the foods provided is the best approach. This action helps the client become more aware of their visual field deficit and encourages them to develop the habit of scanning their environment. Teaching the client to consistently look around their entire visual field promotes independence and helps them adapt to daily activities despite their condition. This strategy supports the goal of rehabilitation, which is to enhance the client's ability to manage their visual impairment independently.
Choice D reason: Prompting the client to rotate his plate to see foods on the right side of the tray is a practical solution, but it does not address the broader need for the client to learn to scan their environment. While rotating the plate may temporarily help the client access the food on the right side, it does not encourage the development of compensatory strategies for the visual field deficit. Encouraging the client to look all over the tray is a more effective approach for long-term adaptation and independence.

Choice A reason: Returning for a urine culture and imaging is an important part of follow-up care for a client with pyelonephritis. These tests can help ensure that the infection has been completely resolved and that there are no underlying structural abnormalities contributing to the condition. However, while follow-up appointments are crucial, the immediate priority for discharge instructions is to emphasize the importance of adhering to the prescribed medication regimen to ensure the effectiveness of the treatment.
Choice B reason: Using nonsteroidal anti-inflammatory drugs (NSAIDs) for pain can help manage discomfort associated with pyelonephritis. However, pain management is secondary to ensuring that the infection is effectively treated. While it is important to address the client's pain, reinforcing the need to follow the prescribed medication regimen takes precedence to ensure that the infection is adequately managed and prevented from worsening or recurring.
Choice C reason: Adhering strictly to the medication regimen is the most important instruction for the client. Ensuring that the client takes the full course of prescribed antibiotics is critical to effectively treating the pyelonephritis and preventing the development of antibiotic resistance or recurrent infections. Reinforcing the importance of completing the antibiotic course as directed helps ensure that the infection is fully eradicated and reduces the risk of complications.
Choice D reason: Ensuring effective perineal hygiene is important for preventing urinary tract infections (UTIs) and maintaining overall urinary health. While it is a relevant aspect of care, it is not the most critical instruction for the client at the point of discharge. The primary focus should be on the adherence to the medication regimen to treat the current infection and prevent further complications. Perineal hygiene practices can be reinforced as part of overall health education but are not the immediate priority compared to medication adherence.