The nurse is caring for a client who just had a radical jaw and neck resection for oral cancer. The nurse has just completed teaching for the spouse and client about tracheostomy care
Which no-tation in the client's chart is the most accurate documentation of the teaching that occurred? a. "The client and spouse were instructed regarding management of mucous plugs and thick secretions."
b. "Information about home oxygen therapy and equipment was provided for the client and spouse."
c. "The client and spouse were shown how to suction the tracheostomy and change the ties."
d. "Correct suctioning procedure was dem-onstrated, and the client's spouse verba-lized two instances when suctioning needs to occur."
D
The documentation should include teaching actions, as well as the spouse's response to the in-structions. The other choices do not indicate the response by the client and spouse to the teach-ing. A return demonstration would be beneficial.
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