A nurse is delegating tasks to the assistive personnel (AP). The nurse should direct the AP to complete which of the following tasks first?

Choice A reason: Initiating a plan of care for a client who is postoperative from an appendectomy is not a task that the RN should delegate to the LPN, as it requires nursing judgment, critical thinking, and assessment skills that are beyond the scope of practice of the LPN. The RN is responsible for developing, implementing, and evaluating the plan of care for each client based on their individual needs, preferences, and goals. The RN can delegate some aspects of the plan of care to the LPN, such as performing routine tasks or monitoring the client's status, but the RN must supervise and evaluate the LPN's performance.

Choice B reason: Administering a tap-water enema to a client who is preoperative is a task that the RN can delegate to the LPN, as it is a standardized procedure that does not require nursing judgment or assessment. The LPN has the knowledge and skills to perform this task safely and effectively, following the established policies and protocols of the facility. The RN should provide clear instructions and expectations to the LPN, such as the type, amount, and temperature of the solution, the position and comfort of the client, and the signs and symptoms to report. The RN should also verify that the LPN has completed the task and documented the outcome.

Choice C reason: Providing discharge instructions to a confused client's spouse is not a task that the RN should delegate to the LPN, as it involves teaching, counseling, and evaluating the client's and family's understanding and readiness for discharge. These are complex activities that require nursing judgment, communication skills, and evaluation skills that are beyond the scope of practice of the LPN. The RN is responsible for ensuring that the client and family receive adequate information and education about the client's condition, treatment, medications, follow-up care, and community resources. The RN can delegate some aspects of discharge planning to the LPN, such as collecting data or providing reinforcement of teaching, but the RN must supervise and evaluate the LPN's performance.

Choice D reason: Catheterizing a client who has not voided in 8 hours is a task that the RN can delegate to the LPN, as it is a standardized procedure that does not require nursing judgment or assessment. The LPN has the knowledge and skills to perform this task safely and effectively, following the established policies and protocols of the facility. The RN should provide clear instructions and expectations to the LPN, such as the type and size of the catheter, the sterile technique, and the urine output measurement. The RN should also verify that the LPN has completed the task and documented the outcome.

Choice E reason: Obtaining vital signs from a client who is 6 hours postoperative is a task that the RN can delegate to the LPN, as it is a routine task that does not require nursing judgment or assessment. The LPN has the knowledge and skills to perform this task safely and effectively, using appropriate equipment and techniques. The RN should provide clear instructions and expectations to the LPN, such as the frequency and parameters of vital signs monitoring. The RN should also verify that the LPN has completed the task and documented the outcome.

Choice A reason: A negative-pressure isolation room is not a suitable room for a client who has scabies. A negative-pressure isolation room is used for clients who have airborne infections, such as tuberculosis or chickenpox. It prevents the contaminated air from escaping the room and infecting other people.

Choice B reason: A positive-pressure isolation room is not a suitable room for a client who has scabies. A positive-pressure isolation room is used for clients who have compromised immune systems, such as those undergoing bone marrow transplants or chemotherapy. It prevents the outside air from entering the room and exposing the client to germs.

Choice C reason: A private room is a suitable room for a client who has scabies. Scabies is a skin infection caused by tiny mites that burrow under the skin and cause intense itching and rash. Scabies can spread easily through direct skin-to-skin contact or sharing personal items, such as clothing or bedding. A private room can prevent the transmission of scabies to other clients or staff.

Choice D reason: A semi-private room with a client who has pediculosis capitis is not a suitable room for a client who has scabies. Pediculosis capitis is an infestation of head lice that feeds on human blood and causes itching and irritation on the scalp. Pediculosis capitis can also spread easily through direct contact or sharing personal items, such as combs or hats. Sharing a room with another client who has pediculosis capitis can increase the risk of cross-infection and complicate the treatment of both conditions.