A nurse is obtaining a weekly weight for a client who has obesity and osteoarthritis and is on a weight management program. The nurse determines that the client gained 1.36 kg (3 lb) in the past week. Which of the following statements should the nurse make?
A “You should try a little harder to stick to your diet.”
B “Why do you think you’ve gained 3 pounds this week?”
C “Were there any issues last week that kept you from focusing on your diet?”
D “You should put this week behind you and adhere to your diet from this point forward.”
The Correct answer and Explanation is:
The correct answer is:
C: “Were there any issues last week that kept you from focusing on your diet?”
Explanation:
In this scenario, the nurse is working with a client who is on a weight management program and has gained 1.36 kg (3 lb) in the past week. The correct response is option C because it encourages an open dialogue that can help identify any underlying issues or barriers that may have contributed to the weight gain. This approach reflects a supportive, non-judgmental attitude that prioritizes understanding and collaboration, which is essential in patient-centered care.
Rationale for Option C:
- Exploration of Barriers: The nurse’s question in option C is designed to explore whether any specific factors—such as stress, social events, physical limitations, or emotional challenges—impacted the client’s ability to adhere to the weight management program. Understanding these factors is crucial for providing appropriate support and guidance.
- Non-Judgmental Approach: This option avoids placing blame or making the client feel guilty about the weight gain. Instead, it fosters a safe environment where the client can discuss challenges openly, which is key to sustaining long-term behavior change.
- Collaborative Problem-Solving: By identifying potential obstacles, the nurse and client can work together to develop strategies to address them. This collaborative approach enhances the client’s sense of empowerment and increases the likelihood of success in the weight management program.
Why Other Options Are Less Appropriate:
- Option A (“You should try a little harder to stick to your diet.”): This statement can be perceived as dismissive or judgmental. It focuses on the client’s effort rather than understanding the reasons behind the weight gain. This could lead to feelings of shame or discouragement, which may negatively impact the client’s motivation.
- Option B (“Why do you think you’ve gained 3 pounds this week?”): Although this question invites reflection, it may come across as accusatory or confrontational. The wording lacks empathy and may make the client feel defensive rather than supported.
- Option D (“You should put this week behind you and adhere to your diet from this point forward.”): While this statement encourages the client to move forward, it misses an opportunity to explore the causes of the weight gain. Without addressing potential barriers, the client may continue to struggle with similar challenges in the future.
In summary, the most therapeutic and effective response is option C because it opens the door for meaningful conversation and problem-solving, which are essential components of effective nursing care and patient-centered support in a weight management program.