A charge nurse pulls a new nurse to the side to discuss documenting a patient’s blood pressure of 202/122 mmHg without reporting it. The patient is now in the ICU. How does the charge nurse best explain how this reflects negligence?

Choice A reason: Asking the client’s full name and date of birth ensures accurate identification, aligning with the Joint Commission’s two-identifier protocol. This method confirms the client’s identity directly, reducing medication errors and ensuring safety, as it is reliable and patient-specific, per medication administration standards.

Choice B reason: Verifying the client’s room number is unreliable, as patients may change rooms or share spaces. Room numbers are not unique identifiers and risk misidentification, leading to medication errors. This method fails to meet safety standards for patient verification, per hospital safety protocols.

Choice C reason: Checking the client’s name on the MAR is part of the process but insufficient alone, as it does not confirm the client’s identity at the bedside. Without direct patient verification, errors may occur if MARs are mismatched, making this inadequate, per medication safety guidelines.

Choice D reason: Asking a family member to verify identity is unreliable, as they may be mistaken or unavailable. Direct patient identifiers, like name and date of birth, are required to ensure accuracy, reducing errors. This method does not meet regulatory standards for patient identification, per safety protocols.

Choice A reason: Onion powder is a spice, not a fat, and contains negligible lipids or calories. It does not influence cholesterol metabolism, blood pressure, or insulin sensitivity, which are critical in managing hyperlipidemia, hypertension, and Type I diabetes. These conditions increase atherosclerosis risk via elevated LDL cholesterol, but onion powder has no role in lipid metabolism or cardiovascular health, making it irrelevant.

Choice B reason: Saturated fats, found in animal products and some plant oils, increase LDL cholesterol by enhancing hepatic production of very-low-density lipoprotein (VLDL). In patients with hypertension and Type I diabetes, this exacerbates atherosclerosis, raising cardiovascular risk. Limiting saturated fats reduces LDL levels, improves endothelial function, and supports glycemic control, aligning with dietary guidelines for these chronic conditions.

Choice C reason: Pepper is a spice with no significant fat content or impact on lipid metabolism. It does not contribute to cholesterol levels, blood pressure, or insulin resistance, which are concerns in hyperlipidemia, hypertension, and Type I diabetes. These conditions require limiting fats that elevate LDL, but pepper has no effect on lipid profiles or cardiovascular risk factors.

Choice D reason: Polyunsaturated fats, like omega-3 and omega-6 fatty acids, lower LDL cholesterol and reduce inflammation, benefiting cardiovascular health. In patients with hypertension and diabetes, these fats improve lipid profiles and endothelial function, reducing atherosclerosis risk. The dietician would encourage, not limit, polyunsaturated fats to support heart health and insulin sensitivity in managing these conditions.