A nurse is updating a postoperative client's plan of care. The nurse should include which of the following as the priority interventions?

Reposition the client frequently.

Instruct the client to use the incentive spirometer.

Increase the amount of time the client spends out of bed each day.

Ensure the client consumes an adequate amount of fluids.

Answer and Explanation

The Correct Answer is B

A.   Reposition the client frequently: While repositioning is important for preventing pressure ulcers and maintaining comfort, it may not be the priority immediately postoperatively compared to other interventions.
B.   Instruct the client to use the incentive spirometer: This is the correct answer. Incentive spirometry helps prevent atelectasis and respiratory complications postoperatively, making it a priority intervention to include in the plan of care.
C.   Increase the amount of time the client spends out of bed each day: Early ambulation is important for preventing complications such as deep vein thrombosis and pneumonia, but it may not be the priority immediately postoperatively depending on the client's condition and surgical procedure.
D.   Ensure the client consumes an adequate amount of fluids: While hydration is important for postoperative recovery, ensuring adequate fluid intake may not be the priority compared to interventions aimed at preventing respiratory complications such as atelectasis.

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Correct Answer is C

Explanation

A: This action does not address the issue of the nurses' unwillingness to care for the patient and fails to resolve the conflict or the underlying concerns about infection control and staff safety.

B: Termination is a drastic measure that may not be justified without a thorough investigation and should be considered only after other conflict resolution strategies have failed.

C: Moving the discussion to a private area is appropriate to maintain professionalism and confidentiality, allows for a calm environment to discuss the matter thoroughly, and prevents further disruption of the workplace.

D: Involving the house supervisor is a step that could be taken if the charge nurse is unable to resolve the conflict, but it is not the first action that should be taken as the charge nurse has the authority to manage staff issues directly

A. Whether the facility ethics committee reaches a consensus on the case B. Whether the client's refusal is based on religious belief C. Whether the partner is the client's durable power of attorney for health care D. Whether the client understands the risk of refusing the procedure

Correct Answer is D

Explanation

A. The facility ethics committee can provide guidance and recommendations, but they do not have the authority to override a competent client's decision regarding their own medical treatment. Their role is advisory rather than decisive.

B. While a client's refusal based on religious beliefs must be respected, it is not the primary deciding factor in this scenario. The key issue is the client's understanding and informed consent, regardless of the reason for refusal.

C. If the partner is the client's durable power of attorney for health care, they can make decisions on behalf of the client only if the client is deemed incompetent. In this case, the client is competent and has made their own decision.

D. The client's understanding of the risks associated with refusing the procedure is crucial. Informed consent requires that the client comprehends the potential consequences of their decision, ensuring that their refusal is based on a clear understanding of the risks involved.

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A nurse is updating a postoperative client's plan of care. The nurse should include which of the following as the priority interventions?

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Naxlex Comprehensive Predictor Exams

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