A nurse is asked by the unit manager to provide input for the performance appraisal of an assistive personnel (AP). Which of the following actions should the nurse take?

A. Initiate a 24-hr urine collection for a client who has end-stage kidney disease:

While a 24-hour urine collection is important for assessing kidney function, it is not an urgent task and can be scheduled at a later time without compromising the client's immediate well-being.

B. Change the dressing for a client who has a decubitus ulcer:

Changing the dressing for a decubitus ulcer is important for wound care, but it is not as urgent as addressing respiratory distress in a client with COPD.

C. Administer an antibiotic for a client who has methicillin-resistant Staphylococcus aureus:

Administering an antibiotic for a client with a methicillin-resistant Staphylococcus aureus (MRSA) infection is important, but it is not as immediately critical as ensuring adequate oxygenation in a client with COPD. Respiratory issues take precedence in the hierarchy of priorities.

D. Initiate oxygen therapy via nasal cannula for a client who has COPD.

The priority should be given to tasks that address immediate threats to the client's well-being or safety. In this scenario, initiating oxygen therapy for a client with COPD is a priority because it addresses respiratory distress and hypoxia, which are critical concerns in individuals with COPD. Respiratory interventions take precedence to ensure adequate oxygenation.

Ask the APs to discontinue the conversation:

This is the most appropriate immediate action. Discussing a client's care in a public area violates the principle of patient confidentiality. The nurse should intervene promptly and ask the assistive personnel to stop the conversation.

Inform the client what has occurred:

While transparency with the client is important, it may not be the first action to take in this situation. The priority is to address the breach of confidentiality by stopping the conversation.

Notify the client's provider:

Notifying the client's provider is not the initial action to take in this situation. First, the nurse should address the immediate issue by stopping the inappropriate conversation. The provider may be informed later, if necessary.

Schedule a disciplinary conference for the APs:

Scheduling a disciplinary conference is a step that may be taken after addressing the immediate issue. The priority is to stop the inappropriate conversation and address confidentiality concerns before considering disciplinary actions.