The nurse offers to bathe the client, and the client declines. What is the best way for the nurse to document this situation?
1. The client is refusing all care today.
2. The client is being noncompliant today.
3. Client stated, "I do not want a bath today."
4. The client did not want a bath today.
3
Rationale: Whenever possible, it is best to record the client's actual statement. To say that the client is refusing all care today is inaccurate, as the client only refused the bath. Writing that the client is noncompliant is a judgment. Charting that the client did not want a bath is inaccurate because perhaps the client did want a bath but didn't want it at that time. If charting exactly what the client said, there can be no misinterpretation.
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