A nurse is serving on a committee that is developing infectious disease protocols. Which of the following instructions should the nurse include in the protocol for clients who have Clostridium difficile?

A. A dietitian is typically involved in addressing nutritional needs and dietary concerns. While nutrition is important for overall health, it may not directly address the client's difficulty with fine motor skills.

B. A physical therapist is more focused on addressing gross motor skills, mobility, and physical function. While physical therapy may be beneficial for individuals with rheumatoid arthritis, it may not specifically address fine motor skill difficulties.

C. A pharmacist is responsible for managing medications and providing information about medications. While medication management is crucial for clients with rheumatoid arthritis, a pharmacist is not the primary referral for addressing fine motor skills.

D. Occupational therapist is the most appropriate referral for a client with difficulty in fine motor skills. Occupational therapists specialize in helping individuals develop or regain the skills needed for daily living activities, including fine motor skills. They can provide strategies, exercises, and adaptive techniques to improve the client's ability to perform activities such as dressing, grooming, and other tasks requiring fine motor coordination.

A. Report the occurrence to the nursing supervisor:

While reporting the occurrence is important, verifying the DNR status takes precedence. The nurse needs to gather information and confirm whether the patient has a current DNR order before escalating the issue to a higher authority.

B. Complete an incident report stating the facts of the situation:

Completing an incident report is a part of the process, but it should not be the first action. The immediate concern is to determine if the patient has a valid DNR order. An incident report can be completed later to document the situation and any actions taken.

C. Verify the DNR prescription is current in the medical record.

Verifying the DNR (do-not-resuscitate) prescription is the first and most immediate action the nurse should take. It is crucial to confirm the current status of the DNR order to ensure that the healthcare team is following the patient's wishes. If the DNR is indeed valid and up-to-date, it means the resuscitation efforts, including CPR, were contrary to the patient's expressed wishes.

D. Request a meeting with the ethics committee:

Contacting the ethics committee may be necessary depending on the circumstances, but it is not the first step. Verifying the DNR status is an immediate action that can guide subsequent decisions. If there are ethical concerns or conflicts, involving the ethics committee can be considered after confirming the facts surrounding the DNR order.