A nurse on a medica-surgical unit is caring for a client who asks about advance directives and states that he wants to appoint a health care proxy. Which of the following responses should the nurse make?

a. Administering an enema is a routine nursing task that can be delegated to an LPN, who is trained to perform such duties.
b. Developing an initial plan of care for a newly admitted client with sickle cell anemia involves comprehensive assessment and planning, which is typically the responsibility of an RN.
c. A client transferring from the CCU after a myocardial infarction would require complex care and monitoring, which is beyond the LPN’s scope of practice.
d. Initial teaching on self-administration of insulin involves patient education and assessment of understanding, which is more appropriate for an RN to handle.

- Choice A: Storing opened bottles of normal saline in a refrigerator for up to 48 hours is not recommended because it poses a risk of bacterial contamination. Saline is a sterile solution, and once opened, it should be used within a specific time frame, typically 24 hours, to ensure safety and efficacy.
- Choice B: Waiting to dispose of sharps containers until they are completely full is not advisable due to safety concerns. Overfilled sharps containers can increase the risk of needle-stick injuries, which can lead to serious infections. It is essential to follow proper disposal protocols to maintain a safe environment for both patients and healthcare workers.
- Choice C: Using clean gloves rather than sterile gloves for colostomy care is an appropriate action to include in a cost-containment plan. Clean gloves are sufficient for colostomy care because the stoma is considered a clean, not sterile, area. This practice can reduce costs without compromising patient care.
- Choice D: Returning unused supplies from the bedside to the unit’s supply stock is generally not appropriate because it can lead to cross-contamination. Once supplies are taken to a patient's bedside, they should not be returned to the general supply to prevent the spread of infection.