A charge nurse is admitting a client who has bipolar disorder and who is in the manic phase. Which of the following room assignments should the nurse give the client?

A. The hospital supervisor is responsible for overseeing the day-to-day operations of the hospital, including staff management. However, in the immediate chain of command, the supervisor might not be the first point of contact for specific unit issues unless the concern escalates beyond the unit level.
B. The charge nurse is the immediate supervisor on the unit and is usually the first point of contact for issues related to staff behavior or performance. Reporting the concern to the charge nurse is appropriate because they have the responsibility to oversee the staff on the unit, address concerns, and ensure the safety and well-being of both patients and staff. The charge nurse can assess the situation and take appropriate action, such as further investigation or reporting to higher authorities.
C. The unit director is responsible for overall management and administration of the unit, including staff issues. While the unit director is a higher level of authority than the charge nurse, it is often appropriate to first report to the charge nurse, who is closer to the situation and can address it more immediately.
D. The Chief Nursing Officer (CNO) is a top executive responsible for nursing practices across the entire hospital or healthcare system. Reporting directly to the CNO is generally not the first step in the chain of command for concerns about a coworker’s impairment.

A. A case manager coordinates and manages the overall care of the client, particularly when there are multiple healthcare needs or transitions in care. Given that the client has just experienced a CVA, the case manager could be crucial in coordinating care, arranging for additional services, and ensuring continuity of care, especially since the client lives alone.
B. The client is experiencing wheezing in the upper lobes of the lungs and is receiving supplemental oxygen. A respiratory therapist would be instrumental in evaluating and managing the client's respiratory status, including optimizing oxygen therapy and addressing any issues related to asthma or lung function.
C. There is no mention of diabetes in the client's history or current symptoms. The focus of the client's care is on managing the effects of the CVA and respiratory issues. Therefore, a referral to a diabetes nurse educator is not indicated based on the provided information.
D. The client has flaccid extremities with decreased muscle tone and strength following the CVA. A physical therapist would be essential for assessing and providing therapy to improve mobility, strength, and function in the affected extremities. This referral is appropriate for addressing the physical impairments resulting from the CVA.
E. The client is having difficulty with self-feeding due to decreased muscle tone and strength, which impacts daily activities. An occupational therapist can help with adaptive techniques and strategies for self-care tasks, such as feeding, and provide interventions to improve the client’s ability to perform daily activities independently. This referral is appropriate for addressing functional challenges related to the CVA.
F. An enterostomal therapy nurse specializes in wound care, ostomy management, and incontinence care. There is no indication in the provided information that the client has any issues related to wounds, ostomies, or incontinence. Therefore, a referral to an enterostomal therapy nurse is not indicated based on the current information.