A nurse in a clinic is teaching a client who has diabetes mellitus about self-administration of insulin using a prefilled, multidose pen. Which of the following instructions should the nurse include?

A. Urinary catheter care:

While urinary catheter care is important for maintaining urinary hygiene and preventing urinary tract infections, it is not as urgent as addressing respiratory needs. If the client is stable and not experiencing acute urinary retention or other urinary complications requiring immediate intervention, urinary catheter care can be performed after addressing respiratory concerns.

B. Wound irrigation:

Wound irrigation is typically performed to clean and debride wounds, promoting healing and preventing infection. While wound care is essential for preventing complications, it is not as urgent as ensuring adequate respiratory function, particularly in a client with an artificial airway requiring suctioning.

C. Enteral feeding:

Enteral feeding is crucial for providing nutrition to clients who cannot consume adequate nutrients orally. However, initiating enteral feeding can wait until the client's respiratory needs are addressed, as the immediate priority is to ensure effective breathing and oxygenation.

D. Endotracheal suctioning

Endotracheal suctioning is a critical procedure performed to clear secretions from the airway, ensuring adequate oxygenation and ventilation in patients with artificial airways such as endotracheal tubes. Maintaining a patent airway is a fundamental aspect of patient care, and suctioning helps prevent airway obstruction, hypoxia, and respiratory distress. Therefore, it takes precedence over other procedures in ensuring the client's respiratory stability and preventing potential complications.

A. A nurse administers a medication without first identifying the client.

Negligence refers to the failure to provide care that a reasonable and prudent person would normally perform in a similar situation, resulting in harm to the client. In this scenario, administering medication without first identifying the client constitutes negligence because it violates the standard of care expected of a nurse. Proper identification of the client is essential to ensure that the correct medication is administered to the right individual, preventing medication errors and potential harm.

B. A nurse begins a blood transfusion without obtaining consent from a client:

This situation involves a failure to obtain informed consent, which is a violation of the client's rights but does not necessarily constitute negligence. Negligence typically involves a failure to provide proper care rather than a failure to obtain consent.

C. An assistive personnel prevents a client from leaving the facility:

While preventing a client from leaving the facility without appropriate authorization may be inappropriate or a breach of the client's rights, it does not necessarily constitute negligence. Negligence involves a failure to provide care that meets the standard of care expected in a given situation.

D. An assistive personnel discusses client care in the facility cafeteria with visitors present:

This situation may involve a breach of confidentiality or privacy but does not constitute negligence unless the discussion leads to harm or adverse consequences for the client. Negligence typically involves a failure to provide care that results in harm or injury to the client.