A nurse is caring for a client who is to receive a transfusion of packed RBCs. Which of the following actions should the nurse take?

A. "The nurse will initiate acupuncture when I arrive at the unit.": Acupuncture must be performed by a trained and licensed practitioner, not a bedside nurse. While it can be used for labor pain, it is not typically initiated by nursing staff upon admission.

B. "I can use my ultrasound picture as a focal point during contractions.": Focal point techniques, such as concentrating on a meaningful object like an ultrasound picture, help distract from pain and promote relaxation.

C. "A transcutaneous electrical nerve stimulator will help with pelvic pressure.": TENS units are primarily effective for back pain in early labor rather than pelvic pressure. They work by stimulating sensory nerves to reduce pain perception but are less effective for deep pelvic discomfort.

D. "My nurse can teach me biofeedback at the beginning of labor.": Biofeedback requires prior training and practice before labor begins to be effective. Learning it for the first time during active labor is impractical and unlikely to yield good results.

Rationale:

A. Perform a sterile dressing change for a client who has an abdominal wound: LPNs can perform sterile procedures and wound care on stable clients, making this an appropriate delegated task.

B. Complete the Glasgow Coma Scale for a client who has an evolving stroke: Neurological assessments on unstable or acutely changing clients require RN judgment and should not be delegated to an LPN.

C. Perform an admission assessment for a client who is scheduled for surgery: Admission assessments require comprehensive data collection, interpretation, and nursing judgment, which fall under the RN scope of practice.

D. Complete discharge teaching for a client who has a new diagnosis of diabetes mellitus: Discharge teaching for a new condition involves complex education and evaluation of understanding, which are RN responsibilities.