A nurse is providing teaching to a client who is to undergo a cardiac catheterization. Which of the following findings is expected during the procedure?

Rationale:

A. Institutional policies and procedures: While helpful in guiding facility-specific protocols, policies do not override state regulations. An institution may allow tasks that exceed or fall short of legal scope, so this should not be the primary reference.

B. Written prescription from the provider: A provider’s order does not define or expand a nurse’s legal scope of practice. Even with a valid order, the nurse must independently verify whether they are legally permitted to carry out the task.

C. State Nurse Practice Act: The Nurse Practice Act (NPA) is the legal authority that defines what licensed nurses are permitted to do in their state. It is the most authoritative resource to determine whether a task is within the nurse’s legal scope of practice.

D. Verbal direction from the nurse manager: Even when given by a superior, verbal instructions must still comply with state law. A nurse manager’s guidance cannot authorize a task that lies outside the nurse’s legal scope.

Rationale:

A. Probiotics: Probiotics are used to support gastrointestinal and immune health and do not significantly affect blood pressure or pose a known risk for intraoperative hypotension.

B. Black Cohosh: Black cohosh is often used to manage menopausal symptoms and is known to cause vasodilation, which can lower blood pressure. When combined with anesthetic agents, it can potentiate hypotensive effects during surgery.

C. Soy: Soy is consumed for its phytoestrogenic effects but does not have a direct or significant hypotensive action that increases surgical risk. Its impact on intraoperative blood pressure is minimal.

D. Flaxseed: Flaxseed may offer mild antihypertensive effects over time due to its omega-3 content, but it is not typically associated with clinically significant drops in blood pressure during surgery.