A nurse overhears two staff members talking in the cafeteria about a client's scheduled surgery. Which of the following actions should the nurse take?

A. While senior management plays a critical role in overall budgetary planning, involving staff in budgetary decisions can be important for identifying cost-saving opportunities and improving financial management at all levels.
B. Encouraging staff to participate in quality improvement projects is an effective way to reduce costs. Quality improvement initiatives often focus on enhancing efficiency, reducing waste, and improving patient outcomes. By involving staff in these projects, the organization can identify areas where cost savings can be achieved without compromising care quality.
C. While additional assistive personnel might improve patient care and staff workload, it does not directly address cost reduction. Staffing an extra person each shift can increase costs rather than reduce them. Cost reduction strategies should focus on improving efficiency and reducing waste rather than simply adding resources.
D. Planning budget needs based on an average client stay over 6 months might not be the most effective approach. Budget planning should consider more dynamic factors, such as current patient volume, acuity, and shorter-term trends. Relying on average stay data might not accurately reflect current needs and could lead to either overestimating or underestimating the budget requirements.

A. Distended neck veins can indicate right-sided heart failure or cor pulmonale, a complication often associated with advanced COPD. COPD can lead to increased pressure in the pulmonary arteries, which in turn can cause right-sided heart failure. Notifying the charge nurse about this finding is important for timely intervention and management.
B. For clients with COPD, maintaining oxygen saturation above 95% might not always be appropriate. These patients often have chronically low oxygen levels and have adapted to lower oxygen saturation. Overly aggressive oxygen therapy can lead to CO2 retention and worsen respiratory status.
C. Clubbing of the fingernails can be associated with chronic hypoxia and various respiratory conditions. While it is important to document and monitor changes in clubbing, it is not usually an acute or immediate reason to call the provider unless there are other concerning symptoms.
D. Ambulating a client with COPD just before meals might not be advisable. COPD clients can become easily fatigued and may have difficulty breathing with exertion. It is generally better to have clients with COPD ambulate at times when they are less likely to be fatigued or short of breath, and usually after meals rather than before.