After implementation of new policies related to client identification prior to medication administration, the frequency of medication errors remains unchanged. Which should be the nurse manager's next action?

Choice A reason: A business executive admitted with Guillain-Barre syndrome who has residual bilateral numbness in the lower extremities is not the most important client to schedule a multi-disciplinary team meeting for. This client may have a complex and chronic condition, but it is not an acute or urgent situation that requires immediate collaboration and coordination of care.

Choice B reason: A woman who is pregnant with twins and whose due date is one week away is not the most important client to schedule a multi-disciplinary team meeting for. This client may have a high-risk pregnancy, but it is not a complicated or emergent case that requires intensive and comprehensive care.

Choice C reason: An elderly client admitted through the emergency department with a broken hip whose blood glucose is 400 mg/dL (22 mmol/L) is the most important client to schedule a multi-disciplinary team meeting for. This client has a serious and potentially life-threatening condition that requires prompt and effective management of pain, infection, surgery, mobility, nutrition, and diabetes. A multi-disciplinary team meeting can facilitate the communication and collaboration among the healthcare professionals involved in the client's care and ensure the best possible outcomes.

Choice D reason: A 2-year-old who contracted Hepatitis A while at a local daycare center is not the most important client to schedule a multi-disciplinary team meeting for. This client may have a contagious and unpleasant infection, but it is not a severe or critical condition that requires extensive and holistic care.

hoice A reason: The client exhibiting signs of Addison's crisis after corticosteroids were discontinued is the most important client to assign to the nurse. The client is at risk of life-threatening complications such as hypotension, shock, hyponatremia, hyperkalemia, and metabolic acidosis. The client requires close monitoring, frequent assessment, and prompt intervention. The nurse has the knowledge and skills to manage the client's condition and administer the necessary medications such as hydrocortisone, fluids, and electrolytes.

Choice B reason: The client newly diagnosed with hypothyroidism and who is to receive the first dose of levothyroxine is not the most important client to assign to the nurse. The client may have symptoms such as fatigue, cold intolerance, weight gain, and constipation, but the condition is not life-threatening or unstable. The client requires education, support, and medication administration. The PN can perform these tasks under the supervision of the nurse.

Choice C reason: The client with diabetes and has an elevated serum glycosylated Hgb (Hgb A1C) is not the most important client to assign to the nurse. The client may have poor glycemic control and long-term complications such as retinopathy, nephropathy, and neuropathy, but the condition is not life-threatening or unstable. The client requires education, diet modification, and medication administration. The PN can perform these tasks under the supervision of the nurse.

Choice D reason: The client two days post-thyroidectomy and is unable to speak clearly due to laryngeal nerve damage is not the most important client to assign to the nurse. The client may have difficulty communicating, swallowing, and breathing, but the condition is not life-threatening or unstable. The client requires observation, comfort measures, and alternative methods of communication. The PN can perform these tasks under the supervision of the nurse.