A nurse is caring for a client who has a prescription for intravenous therapy. The nurse has not performed venipuncture before. Which of the following actions should the nurse take?

Rationale:

A. Inserting a nasogastric (NG) tube is an invasive procedure that requires knowledge of anatomy, patient assessment, and potential complications. It involves clinical judgment and skill; therefore, it cannot be delegated to an assistive personnel (AP). Only licensed nurses with the necessary competency should perform this task.

B. Performing a simple dressing change is considered a routine, non-invasive task that follows established protocols and does not require independent nursing judgment. An AP can safely remove and replace clean dressings or assist with basic wound care, allowing the nurse to focus on more complex care, assessments, or procedures that require critical thinking.

C. Providing advice to a client over the telephone involves assessing symptoms, prioritizing care, and making clinical decisions. This is within the scope of practice of a registered nurse, as it requires professional judgment, and cannot be delegated to an AP. Providing advice incorrectly could lead to harm.

D. Teaching a client how to walk on crutches is an educational intervention that requires the nurse to assess the client’s physical ability, balance, and coordination. The nurse also ensures safety and correct technique. This task cannot be delegated to an AP, as it requires assessment, instruction, and judgment.

Rationale:

A. Pain when chewing solid foods is primarily related to temporomandibular joint dysfunction or dental issues. This concern falls under the care of dentists or medical providers, rather than occupational therapy, as it does not involve ADLs or functional independence.

B. Difficulty ambulating with a walker involves mobility, balance, and lower extremity function, which are typically addressed by a physical therapist. Physical therapy focuses on improving strength, gait, and safe ambulation, whereas occupational therapy focuses on upper-body function and activities of daily living.

C. Requiring assistance with completing oral hygiene indicates difficulty with self-care tasks, a primary focus of occupational therapy. Occupational therapists assess limitations in ADLs, provide adaptive techniques or devices (e.g., built-up toothbrush handles, assistive grips), and develop individualized plans to help clients maintain independence and perform daily tasks safely. For a client with rheumatoid arthritis, joint pain and reduced dexterity can impede the ability to complete these tasks, making occupational therapy essential.

D. Expressing the desire to join a support group addresses emotional and social support needs, which are typically facilitated by a social worker or counselor, not an occupational therapist. While important for holistic care, this does not fall under the scope of occupational therapy.