A young male client who is being taught to use an inhaler for symptoms of asthma tells the nurse that he will use the inhaler but, plan to continue smoking cigarettes. In evaluating the client's response, what is the best initial action by the nurse?

A. Revise the plan of care based on the client's plans to continue smoking.

B. Explain that denial of illness can interfere with the treatment regimen.

C. Inform the health care provider of this statement made by the client

D. Review factors surrounding client's beliefs about smoking cessation.

 

D. Review factors surrounding client's beliefs about smoking cessation.

Step-by-step explanation

Although options B and C are appropriate for the given situation, the question asks for the BEST INITIAL action by the nurse in this situation. Options B and C can come after the nurse has done option D. A patient's lack of motivation is the most important barrier to smoking cessation. The nurse must review factors from the history and during the interview about his beliefs on smoking cessation. By knowing his beliefs about smoking cessation, we can understand the patient better and approach and advise against smoking in a clear, strong, and personalized manner. Appropriate interventions can then be done based upon the patient's willingness to quit.

Option A is obviously wrong because we never adjust our treatment plan to cater to the patient's preference to continue smoking. Smoking is strongly discouraged in patients with asthma because smoking irritates the airway and is strongly associated with the onset of asthma.