A nurse is talking with a client who is scheduled for surgery to repair retinal detachment. Which of the following preoperative instructions should the nurse include?

Choice A reason:

Washing the cord daily with mild soap and water is not recommended. The best practice is to keep the umbilical cord stump clean and dry. Cleaning it with water and mild soap can be done if it gets dirty, but it should not be a daily routine as it might delay the drying process.

Choice B reason:

Applying petroleum jelly to the cord stump is not advised. The goal is to keep the stump dry to promote natural drying and falling off. Petroleum jelly can keep the area moist, which is counterproductive to the drying process.

Choice C reason:

Covering the cord with the diaper is not recommended. Instead, the diaper should be folded down below the umbilical cord stump to keep it exposed to air and prevent irritation from urine or stool3. This helps the stump to dry out and fall off naturally.

Choice D reason:

Giving a sponge bath until the cord stump falls off is the correct instruction. Submerging the baby in water can delay the drying and falling off of the stump. Sponge baths help keep the area dry and clean, promoting faster healing.

Choice A reason:

The statement “The nurse identifies a broken piece of equipment” is important for safety and should be reported to the appropriate department for repair or replacement. However, it does not typically require an incident report unless the broken equipment caused harm or had the potential to cause harm to a patient. Incident reports are generally used to document events that are not consistent with the routine operation of the healthcare unit or the standard care of a patient.

Choice B reason:

The statement “The nurse has a disagreement with the nursing supervisor about inadequate staffing” reflects an internal issue that should be addressed through appropriate channels, such as a staff meeting or a discussion with human resources. It does not typically require an incident report unless the disagreement led to a situation that compromised patient safety or care. Incident reports are meant to document events that directly affect patient care and safety.

Choice C reason:

The statement “A staff member does not show up to work her assigned shift” is a staffing issue that should be managed by the nursing supervisor or the staffing coordinator. While it can affect the workflow and staffing levels, it does not usually require an incident report unless it directly impacts patient care or safety. Incident reports are used to document specific events that deviate from standard care practices and have the potential to harm patients.

Choice D reason:

The statement “A client discovers that his dentures are missing” is a situation that requires an incident report. The loss of a client’s personal belongings, especially something as essential as dentures, can significantly impact the client’s well-being and quality of care. Documenting this incident helps to investigate the circumstances, prevent future occurrences, and ensure that appropriate measures are taken to address the client’s needs. Incident reports are crucial for tracking and addressing issues that affect patient care and safety.