A nurse is caring for a client following bilateral knee replacement surgery and they require assistance with dressing. The nurse should report this information to which of the following interdisciplinary team members?

A. Clarify the prescription for amoxicillin with the provider: Amoxicillin is a penicillin derivative, and the client has penicillin allergy. Administering this medication could cause an allergic reaction. The nurse should contact the provider to prescribe an alternative antibiotic.

B. Ensure the client wears a surgical mask when they are outside of their room: A surgical mask is not necessary for a urinary tract infection, as UTIs are not spread via respiratory droplets. The client does not require respiratory precautions.

C. Recommend increasing the dose of metoprolol: The client's blood pressure and pulse are within acceptable ranges, with no indication of inadequate response to metoprolol. There is no need to increase the dose at this time.

D. Request a prescription for an antiemetic medication: The client is experiencing nausea, which could hinder fluid and food intake. An antiemetic could help alleviate symptoms, improve comfort, and support nutritional intake, so requesting one is appropriate.

E. Place the client on contact precautions: The client is on metronidazole, which can be used for C. difficile. The client has loose stools, which may indicate a gastrointestinal infection. Until a definitive diagnosis is made, contact precautions should be implemented to prevent the potential spread of infection to other patients.

F. Hold the dose of levothyroxine: The client’s hypothyroidism is managed with levothyroxine, and there is no indication to hold the medication. Discontinuing it could disrupt thyroid function, so the nurse should continue administering it as prescribed.

A. Reposition the client every 3 hr: This is insufficient. The standard of care for a client at risk is repositioning at least every 2 hours while in bed and every 1 hour while sitting in a chair to ensure adequate blood flow to compressed tissues.

B. Place the client on a donut-shaped cushion: A donut-shaped cushion is not recommended for preventing pressure ulcers. It can increase pressure on the tissue, leading to further complications. A more effective intervention is use of pressure-redistribution surfaces.

C. Elevate the head of the bed to 45°: Elevating the head of the bed can increase pressure on the sacral area and can be uncomfortable for clients with mobility and incontinence issues. The head of the bed should be elevated only when necessary for breathing or comfort, not as a routine practice.

D. Request a consult with a registered dietitian: The client has decreased intake and may be at risk for malnutrition or dehydration. A dietitian’s input is essential to assess nutritional needs, especially for a client with diabetes and decreased mobility, to ensure proper healing and management.

E. Provide a support pressure-redistribution surface: A support pressure-redistribution surface is crucial for this client to reduce the risk of pressure ulcers. These surfaces help alleviate pressure on bony prominences and distribute the body weight evenly to prevent tissue damage.

F. Perform a skin risk assessment weekly: Skin risk assessments should be done more frequently than weekly, especially for a client with decreased mobility, incontinence, and diabetes. Daily or at least twice-weekly assessments are needed to monitor for early signs of skin breakdown.

G. Use a moisture barrier ointment after cleaning the client's skin: Using a moisture barrier ointment is essential for protecting the skin, especially since the client has urinary and fecal incontinence. This will help prevent skin irritation and breakdown caused by exposure to moisture.