A newly hired unlicensed assistive personnel (UAP) is assigned to a home healthcare team along with two experienced UAPs.
Which intervention should the home health nurse implement to ensure adequate care for all clients?
Assign the newly hired UAP to clients who require the least complex level of care.
Ask the most experienced UAP on the team to partner with the newly hired UAP.
Review the UAP's skills checklist and experience with the person who hired the UAP.
Evaluate the newly hired UAP's level of competency by observing the UAP deliver care.
The Correct Answer is D
Choice A rationale:
Assigning the newly hired unlicensed assistive personnel (UAP) to clients who require the least complex level of care is not the best approach to ensure adequate care for all clients. It may limit the UAP's opportunities for learning and growth and may not fully utilize their skills.
Choice B rationale:
Asking the most experienced UAP to partner with the newly hired UAP is a reasonable approach, but it may not provide a comprehensive solution. It can be beneficial for mentorship and guidance, but it may not address all the clients' needs efficiently.
Choice C rationale:
Reviewing the UAP's skills checklist and experience with the person who hired the UAP is an important step in assessing competency. However, it alone may not ensure adequate care for all clients. Competency assessment should be ongoing and include direct observation of care delivery.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Decreasing expiratory flow time is not the appropriate intervention in this case. The client's pH and PaCO2 levels suggest respiratory acidosis, which indicates inadequate ventilation. Increasing expiratory flow time might exacerbate the acidosis by reducing ventilation.
Choice C rationale:
Increasing the rate of ventilation (respiratory rate) is a potential intervention to improve the client's acid-base balance. However, it should be done cautiously and under medical supervision to avoid respiratory alkalosis. It is not the first-line intervention in this scenario.
Choice D rationale:
Increasing the ventilator tidal volume may help improve ventilation, but it should also be done under medical guidance to prevent barotrauma. It is not the initial intervention to address the client's respiratory acidosis.
Correct Answer is D
Explanation
The correct answer is: D. Blood pressure 90/76 mm Hg.
Clonidine is an alpha-2 adrenergic agonist used to manage withdrawal symptoms, but it lowers blood pressure as a side effect. If the client's blood pressure is already low (90/76 mm Hg), administering clonidine could lead to hypotension, putting them at risk for dizziness, fainting, or more severe complications.
Here's why the other options are not contraindications:
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A. Hypertension: Clonidine is actually used to treat high blood pressure, so it wouldn’t be a contraindication.
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B. Apical heart rate 72 beats/minute: This heart rate is within normal limits, so it wouldn’t prevent administration.
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C. Muscle weakness: While clonidine can cause fatigue, muscle weakness is not a direct contraindication.
Since the client is experiencing withdrawal symptoms like nervousness and unusual sensations ("bones itching"), monitoring vital signs is critical before giving the medication.
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