Which instruction will the nurse plan to include in discharge teaching for a patient who was admitted with a sickle cell crisis?

Choice A reason: A tongue blade is not typically necessary for a patient with status epilepticus. It is more commonly used for oral care or to check the throat, but it is not essential in this context.
Choice B reason: A urinary catheter is not necessary unless the patient has specific urinary retention issues or requires accurate measurement of urine output. It is not standard equipment for managing status epilepticus.
Choice C reason: A nasogastric tube is not typically required for status epilepticus unless there are specific gastrointestinal issues that need to be addressed. It is not standard equipment for managing status epilepticus.
Choice D reason: A suction set up is essential for a patient with status epilepticus to manage potential airway secretions and prevent aspiration. It ensures that the airway remains clear and reduces the risk of complications.
Choice E reason: An oxygen mask is crucial for a patient with status epilepticus to ensure adequate oxygenation. It helps maintain oxygen levels and supports respiratory function, especially if the patient experiences respiratory distress.
Choice F reason: Side-rail pads are important for patient safety, particularly for a patient with status epilepticus who may be at risk of falls or injury during seizures. They provide a protective barrier and help prevent accidental injury.

Choice A reason:
Monitoring for signs of dehydration is essential because Mr. Carter's symptoms (fatigue, nausea, and jaundice) and laboratory results indicate acute hepatitis A, which can cause significant fluid loss due to nausea and reduced oral intake. Assessing hydration status ensures timely intervention to prevent complications such as hypovolemia. Additionally, high bilirubin levels and elevated liver enzymes suggest hepatic dysfunction, which may impair the body's ability to maintain fluid balance.
Choice B reason:
Educating Mr. Carter on proper hand hygiene is crucial to prevent the transmission of hepatitis A, which is highly contagious and spreads via the fecal-oral route. Since Mr. Carter has recently traveled to an area with poor sanitation, providing education on hygiene practices is an immediate priority to protect others. Proper handwashing with soap and clean water significantly reduces the risk of spreading the infection.
Choice C reason:
Encouraging a high-protein diet to repair liver damage is not appropriate during the acute phase of hepatitis A. Protein metabolism requires significant liver function, which is impaired in Mr. Carter’s case due to elevated ALT and AST levels. Emphasizing adequate hydration and balanced nutrition (without overloading the liver with protein) is more suitable. Dietary recommendations for hepatitis A focus on small, frequent meals and avoiding foods that burden liver function.
Choice D reason:
Administering intravenous antibiotics is unnecessary because hepatitis A is a viral infection, not bacterial. Antibiotics do not address viral infections and would not benefit Mr. Carter’s recovery. Supportive care, including hydration, rest, and symptom management, is the mainstay of treatment for viral hepatitis A.
Choice E reason:
Advising rest and limiting physical activity is vital to support Mr. Carter’s recovery. Fatigue and jaundice indicate that his liver is under significant strain, and rest helps reduce metabolic demands on the liver, allowing it to heal more effectively. Light activity may be reintroduced as symptoms improve, but physical exertion should be avoided during the acute phase.
Choice F reason:
Educating the patient about the need for lifelong hepatitis A vaccination is unnecessary because recovery from hepatitis A usually provides lifelong immunity. Vaccination is more relevant for individuals who are at risk and have not been exposed to the virus. Mr. Carter’s current care plan should focus on managing the acute phase of the disease and preventing transmission to others.