A home health nurse is planning to use nonpharmacological pain relief measures for a client who has severe chronic back pain. Which of the following pain management guidelines should the nurse use?

A. Pain relief from the use of heat and cold continues for several hours after removal of the stimulus: The effects of heat and cold are usually short-term and provide temporary relief while applied. Pain relief typically diminishes shortly after removal. B. Discontinue opioids before trying nonpharmacological methods of pain relief: Nonpharmacological interventions can be used alongside pharmacologic therapy for synergistic pain control. Discontinuing opioids before trying these methods is not recommended and may cause unnecessary suffering. C. Use imagery with clients who have difficulty with focus and concentration: Imagery requires the client to concentrate and visualize, so it is less effective for those who have impaired focus or difficulty with mental visualization. Alternative nonpharmacological strategies should be considered for such clients. D. Distraction changes the client's perception of pain, but it does not affect the cause: Distraction techniques help clients focus attention away from pain, reducing perceived intensity and improving coping, while the underlying pathology remains unchanged.