A nurse has assigned an assistive personnel (AP) to perform a gastrostomy feeding for a client who has been receiving feedings at home. Which of the following actions should the nurse take to monitor the AP's performance of the task?
Tell the AP to list the steps of the task.
Instruct the AP to report back once the task is complete.
Ask the family if the AP performed the task correctly.
Request the AP to provide a return demonstration of the task.
The Correct Answer is D
A. Telling the AP to list the steps of the task is not sufficient to ensure correct performance. It may show knowledge of the steps, but it does not ensure the AP is performing the task correctly or safely.
B. Instructing the AP to report back once the task is complete does not allow the nurse to actively observe the AP’s technique or provide feedback on performance.
C. Asking the family if the AP performed the task correctly may provide subjective input, but the nurse is responsible for assessing and ensuring the proper completion of nursing tasks.
D. Requesting the AP to provide a return demonstration of the task is the best method. This allows the nurse to directly observe the AP’s technique, correct any errors, and ensure that the task is performed according to the prescribed standards. This also serves as a valuable teaching opportunity.
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Related Questions
Correct Answer is D
Explanation
A. Respiratory acidosis is incorrect. Chronic diarrhea typically leads to metabolic acidosis, not respiratory acidosis. Metabolic acidosis occurs due to the loss of bicarbonate through diarrhea, which affects the body’s acid-base balance.
B. Hypermagnesemia is incorrect. Chronic diarrhea is more likely to lead to hypomagnesemia due to the loss of electrolytes through frequent bowel movements, not an increase in magnesium levels.
C. Hypertension is incorrect. Chronic diarrhea generally leads to dehydration and hypotension due to fluid loss rather than high blood pressure.
D. Hypokalemia is correct. Chronic diarrhea causes significant potassium loss, which can result in hypokalemia (low potassium levels). Potassium is lost in the stool, and this depletion can lead to muscle weakness, arrhythmias, and other complications.
Correct Answer is B
Explanation
A. An entry on a nursing blog addressing wound healing: Nursing blogs can offer personal perspectives and experiences but may not always be evidence-based. The information can vary in quality and credibility.
B. A peer-reviewed journal article: This is correct. Peer-reviewed journal articles are the gold standard for evidence-based information because they have been evaluated by experts in the field and provide scientifically validated information.
C. First-hand experience with wound care products: While first-hand experience can be valuable, it is subjective and may not reflect the most current or broad evidence-based practices. It should be supplemented with research.
D. Information from a wound care product vendor: Although vendors may offer useful product-specific details, their information is often biased toward their own products and may not provide the most objective, evidence-based information available.
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