A nurse is caring for a client who has named a person to serve as his health care proxy. The client talks about this type of advance directives. Which of the following statements by the client indicates a need for clarification?

A. Maintain the head of the bed in a flat position for 30 min following medication administration: This option is incorrect because after administering medications through an NG tube, it's crucial to elevate the head of the bed to at least 30 to 45 degrees to minimize the risk of aspiration. Keeping the head of the bed flat increases the likelihood of reflux and aspiration of medication.
B. Mix the three medications together prior to administering: This option is incorrect because mixing medications without specific instructions from the healthcare provider can lead to potential interactions or alterations in the effectiveness of the drugs. Each medication should be administered separately to ensure accurate dosing and prevent potential adverse effects.
C. Rush the NG feeding tube with 30 mL of water immediately: This option is incorrect because while flushing the NG tube with water after medication administration is necessary to ensure that the medications reach the stomach and to prevent tube occlusion, the recommended volume for flushing is typically 30 to 60 mL, not just 30 mL. Using a larger volume of water helps ensure thorough flushing of the tube.
D. Dilute each medication with 10 mL of tap water: This is the correct action. Diluting each medication with 10 mL of tap water is a standard practice to ensure proper administration through an NG tube. Dilution helps prevent tube occlusion and irritation of the gastric mucosa, reducing the risk of complications such as clogging of the tube or local irritation. Additionally, diluting the medications facilitates their passage through the tube and into the stomach, optimizing absorption and effectiveness while minimizing the risk of adverse effects.

A. "If you don't do your share of the work, I will have to inform the nurse manager"
This statement uses a threatening tone and may escalate the conflict. It does not promote open communication or collaboration to resolve the issue. Additionally, threatening to inform the nurse manager immediately can create a hostile work environment.
B. "Several staff members have commented that you don't do your fair share of the work."
While it's important to address concerns, singling out the staff nurse in front of others may cause embarrassment and defensiveness. It's better to address the issue privately to avoid further conflict and maintain professionalism.
C. "I need to talk to you about unit expectations regarding delegating and completing tasks."
This statement acknowledges the need for a discussion about unit expectations regarding delegating and completing tasks. By expressing the intention to have a conversation, it opens the door for dialogue and collaboration between the charge nurse and the staff nurse. This approach promotes a supportive and constructive environment for resolving conflicts and addressing concerns.
D. "You have been very inconsiderate of others by not completing your share of the work."
This statement is accusatory and confrontational, which can lead to defensiveness and resistance from the staff nurse. It does not facilitate effective communication or problem-solving. Constructive dialogue is essential for addressing conflicts and finding mutually beneficial solutions.