The nurse is starting preoperative teaching when the client receives a phone call from work. When the nurse resumes teaching, the client is visibly upset. The most therapeutic initial approach is to:

Question

1. Encourage the client to verbalize concerns and feelings, and then do health teaching when the client is able to listen.
2. Tell the client that it is important to focus on the preoperative teaching so that recovery will be faster.
3. Reassure the client that whatever is happening at work can be dealt with in the workplace.
4. Encourage the client to do problem solving.

Answer 1

1. Encourage the client to verbalize concerns and feelings, and then do health teaching when the client is able to listen.

Rationale:
When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Since the nurse is unaware of the issue and is not knowledgeable of the client's work situation, it is false reassurance to tell the client that the matter can be handled at work. This also belittles the client's independence and self-efficacy, as does recommending problem solving.