A nurse is delegating care to assistive personnel. Which of the following assignments should the nurse make?

Reinforcing teaching with a client about stool specimen collection

Collecting a urine specimen from a client who is experiencing dysuria

Taking the vital signs of a client who is experiencing acute angina

Answering a telephone inquiry about NPO status from a client who is scheduled for a procedure

Answer and Explanation

The Correct Answer is B

A) Reinforcing teaching with a client about stool specimen collection:

This task involves providing education to the client, which requires nursing knowledge and judgment. It is not appropriate to delegate to assistive personnel, as they may not have the necessary training or expertise to provide accurate and comprehensive teaching.

B) Collecting a urine specimen from a client who is experiencing dysuria:

Collecting a urine specimen from a client who is experiencing dysuria is an appropriate task to delegate to assistive personnel. This task involves following a standard procedure for specimen collection and does not require specialized nursing judgment or assessment skills.

C) Taking the vital signs of a client who is experiencing acute angina:

Assessing vital signs, especially in a client experiencing acute angina, requires nursing judgment and the ability to recognize and respond to changes in the client's condition. This task should not be delegated to assistive personnel, as they may not have the training to recognize signs of deterioration or respond appropriately.

D) Answering a telephone inquiry about NPO status from a client who is scheduled for a procedure:

Providing information over the phone regarding NPO (nothing by mouth) status involves assessing the client's specific situation, understanding the procedure's requirements, and potentially making clinical decisions based on the client's condition. This task requires nursing judgment and should not be delegated to assistive personnel.

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Correct Answer is C

Explanation

A) Medication administration record:

While the medication administration record (MAR) is an essential component of the client's medical records and care plan, it may not be directly relevant to the transfer report between healthcare facilities. The MAR typically remains with the client's medical records and is not routinely included in transfer reports. However, information about the client's current medications and any changes in medication regimen may be communicated as part of the transfer report.

B) Name of facility social worker:

While the name of the facility's social worker may be important for ongoing coordination of care and support services, it is not typically included in the transfer report between healthcare facilities. Communication between social workers may occur separately as part of the transition planning process, but it is not a standard component of the transfer report.

C) Need for special equipment:

When transferring a client from one healthcare setting to another, such as from an acute care unit to a long-term care facility, it is crucial to communicate any specific needs or requirements the client may have, including the need for special equipment. This information ensures that the receiving facility is adequately prepared to meet the client's needs upon arrival and can arrange for the necessary equipment or resources to be available. Examples of special equipment may include mobility aids (wheelchair, walker), assistive devices (hearing aids, oxygen concentrators), or specialized medical equipment (wound care supplies, catheters).

D) Health insurance information:

Health insurance information, including details about the client's coverage, billing, and insurance provider, is essential for financial and administrative purposes but may not be directly relevant to the transfer report between healthcare facilities. However, if specific insurance requirements or authorizations are necessary for the client's care at the receiving facility, this information should be communicated as part of the transfer process.

A. Triclosan B. Chlorhexidine gluconate C. Alcohol-based antiseptic rub D. Non-antimicrobial soap

Correct Answer is D

Explanation

A) Triclosan:

Triclosan is an antimicrobial agent commonly found in soaps, hand sanitizers, and other personal care products. While it has broad-spectrum antimicrobial properties, it is not specifically recommended for hand hygiene in the context of C. difficile infection. Alcohol-based antiseptic rubs are preferred due to their rapid and effective action against C. difficile spores.

B) Chlorhexidine gluconate:

Chlorhexidine gluconate is an antimicrobial agent commonly used as a surgical scrub and skin cleanser. While it is effective against a wide range of microorganisms, including bacteria and fungi, its efficacy against C. difficile spores is limited compared to alcohol-based antiseptic rubs. Therefore, it is not the preferred choice for hand hygiene in the context of C. difficile infection.

C) Alcohol-based antiseptic rub:

Hand hygiene is crucial in preventing the transmission of Clostridium difficile, a bacterium that can cause severe gastrointestinal infection. Alcohol-based antiseptic rubs are not highly effective against C. difficile spores. Thorough handwashing with soap and water has demonstrated superior antimicrobial activity compared to alcohol-based rubs and are preferred for hand hygiene in such situations.

D) Non-antimicrobial soap:

Clostridium difficile (C. difficile) is a bacterium that can cause severe gastrointestinal infection, and proper hand hygiene is essential in preventing its transmission. While alcohol-based antiseptic rubs are effective against many pathogens, including C. difficile, non-antimicrobial soap and water are preferred for hand hygiene after caring for a client with C. difficile. Non-antimicrobial soap helps to mechanically remove C. difficile spores from the hands, reducing the risk of transmission. Although alcohol-based rubs are convenient and effective in many situations, they may not be as effective as soap and water for removing spores and should be used in conjunction with thorough handwashing when caring for clients with C. difficile.

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