A nurse manager finds that there has been an increase in urinary tract infections on the unit. To address this problem, which of the following actions should the nurse manager take first?

Choice A rationale:

Involving the client's parents in treatment decisions might not be appropriate if the client does not want them involved. Furthermore, the client's autonomy and wishes should be respected, and decisions about treatment should be primarily based on the client's preferences.

Choice B rationale:

This is the correct response. The nurse should respect the client's decision to discontinue chemotherapy and provide information about palliative care as an alternative option. Palliative care focuses on symptom management and improving the client's quality of life, aligning with the client's wishes to stop chemotherapy.

Choice C rationale:

Contacting the spiritual advisor is not directly related to the client's expressed desire to discontinue chemotherapy. While spiritual and emotional support are important, the primary concern here is addressing the client's medical decisions.

Choice D rationale:

Contacting the client's parents to discuss durable power of attorney is not appropriate if the client does not want them involved in the decision-making process. The client's autonomy and preferences should be respected, and they should be empowered to make their own medical decisions.

Choice A rationale:

The nurse should not include the client's dressing change schedule in the verbal report when transferring care to the medical-surgical unit. While this information is important for the client's care, it is not a priority for the receiving unit to know during the immediate transfer. Dressing change schedules can vary based on the type of surgery and wound healing progress, and the medical-surgical unit will focus on the client's overall condition.

Choice B rationale:

The client's level of consciousness is a critical piece of information to include in the verbal report when transferring care. Changes in level of consciousness can indicate neurological deterioration or potential complications, especially after a major surgery like open heart surgery. This information helps the receiving nurses monitor the client's condition closely and respond appropriately if any deterioration occurs.

Choice C rationale:

While reporting the client's vital signs from the previous shift is important, it might not be the most relevant information during the immediate transfer from the postoperative unit to the medical-surgical unit. Vital signs can change rapidly, and the receiving nurses will assess the client's current vital signs upon arrival. Therefore, this information is not the priority for the verbal report.

Choice D rationale:

The client's occupation is not a critical piece of information to include in the verbal report during a transfer from the postoperative unit to the medical-surgical unit. The primary focus of the transfer report should be on the client's immediate postoperative condition, potential complications, and any other information directly related to their current medical status.