A nurse case manager is coordinating care for a client.

Exhibits

Select the 3 community resources the nurse should refer the client.

A. Changing total parenteral nutrition (TPN) tubing every 48 hours is incorrect. According to most guidelines, TPN tubing should be changed every 24 hours to reduce the risk of infection.

B. Changing peripheral IV primary tubing every 96 hours is a recommended practice in many healthcare settings. It balances infection prevention with cost-effectiveness and is widely accepted for maintaining IV line sterility.

C. Replacing peripheral IV solution bags every 96 hours would not be appropriate, as IV fluid bags should typically be replaced every 24 hours to prevent bacterial contamination.

D. Replacing TPN solution bags every 48 hours is not advisable, as TPN solutions should be replaced every 24 hours to minimize infection risks associated with high-sugar content solutions.

A. Remove the employee from the work environment. While safety is paramount, removing the employee should be a last resort after determining the underlying issues. It does not address the reasons behind the employee's behavior, and it may further exacerbate the problem if there are underlying stressors or personal issues.

B. Create a plan for the employee to overcome their substance use. This option assumes that substance use is the primary issue without further evidence. Addressing potential substance use is important, but creating a detailed plan should come after understanding the employee's situation in a more personalized meeting.

C. Schedule a meeting with the employee to address the occurrence within 24 hr. This action allows the nurse manager to have a direct conversation with the employee to understand their perspective and any potential issues affecting their performance. It demonstrates an attempt to support the employee while addressing performance concerns, creating an opportunity for the employee to express any challenges they may be facing.

D. Coordinate a ride home for the employee. This option may seem compassionate but does not directly address the issue of the employee's behavior or performance. Coordinating transportation does not resolve the ongoing attendance and performance problems and might only serve as a temporary fix without long-term solutions.

E. Have the employee sign a contract acknowledging that substance use will not be tolerated. Although setting clear expectations regarding substance use is important, this should occur after understanding the employee's situation. Simply having the employee sign a contract without discussion may not be effective and could create further resistance or defensiveness in the employee.