A staff nurse is observing a newly licensed nurse suction a client’s tracheostomy.

Which of the following actions by the newly licensed nurse requires intervention by the staff nurse?

This prescription is complete because it includes the medication name, dose, route, and frequency.

A complete prescription should also include the client’s name, date, time, signature of the prescriber, and any special instructions.

Choice A is wrong because it does not specify the dose of cimetidine.

PO twice daily is not enough information to administer the medication safely.

Choice B is wrong because it does not specify the frequency of tetracycline.

200 mg PO is not enough information to administer the medication safely.

Choice C is wrong because it does not specify the route of epoetin alfa.

150 units/kg three times weekly is not enough information to administer the medication safely.

Normal ranges for digoxin are 0.5 to 2 ng/mL for heart failure and 0.8 to 2 ng/mL for atrial fibrillation.

Normal ranges for cimetidine are 50 to 150 ng/mL.

Normal ranges for tetracycline are 1 to 10 mcg/mL.

Normal ranges for epoetin alfa are not applicable as it is a synthetic hormone that stimulates red blood cell production.

The correct first action for the charge nurse to take in response to an increase in facility-acquired catheter infections is toidentify possible precipitating factors related to the infections. This is because understanding the root cause of the problem is crucial before implementing any changes or interventions. By identifying the factors contributing to the increase in infections, the nurse can then develop targeted strategies to address these specific issues.

Now, let’s discuss why the other options are not the first actions to take:

1. Schedule nursing staff training for infection control procedures: While training is important, it should be based on identified needs. Without first understanding the precipitating factors of the increased infections, the training may not address the actual issues at hand.

2. Meet with providers to discuss measures to decrease the infections: This could be a subsequent step after identifying the precipitating factors. Meeting with providers without concrete data or understanding of the problem may lead to ineffective solutions.

3. Revise the current policy for catheter care: Policy revision should be based on evidence and identified needs. It would be premature to revise policies without first understanding what factors are contributing to the increase in infections.

In summary, the first step in addressing a problem is always to understand its causes. Only then can effective solutions be developed and implemented.