At the beginning of the day shift, a team leader delegates the following tasks to the assistive personnel (AP): bathe four clients, distribute fresh water, and obtain the morning vital signs. At noon, the nurse asks the AP to transport one client to physical therapy. The AP reports two clients still need bed baths. Which of the following is an appropriate strategy for the nurse to delegate more effectively in the future?

Rationale for correct choices

• chorioamnionitis: The client’s fever, malodorous vaginal discharge, and tachycardia indicate intra-amniotic infection, making chorioamnionitis the strongest risk. Nitrazine-positive discharge with odor further supports infectious etiology rather than labor-only changes. These findings align with hallmark signs of chorioamnionitis in term pregnancy.

• Temperature: A maternal temperature of 38.7° C demonstrates systemic inflammatory response and is a key diagnostic criterion for intra-amniotic infection. Fever combined with localized vaginal changes increases the likelihood of infection within the amniotic cavity. This makes elevated temperature the most appropriate evidence for the selected risk.

Rationale for incorrect choices

• Abruption placenta: Abruption typically presents with painful bleeding, uterine rigidity, or fetal distress, which are absent here. The client’s symptoms instead center on infection indicators rather than placental separation. No hemodynamic instability or abdominal pain consistent with abruption is reported.

• urinary tract infection: Although leukocyte esterase is positive, the client’s primary symptoms—fever, malodorous discharge, nitrazine-positive fluid—point toward reproductive tract infection rather than urinary involvement. The urinalysis lacks nitrites or other strong evidence of a bacterial UTI. These findings are less consistent than those for chorioamnionitis.

• Contraction patterns: Frequent contractions occur in normal labor progression and do not specifically indicate infection. There is no abnormal uterine activity pattern linked to chorioamnionitis risk. Therefore, contraction pattern does not serve as the defining evidence for this condition.

• Fetal heart rate: A normal baseline FHR of 140/min does not signal infection or distress. Fetal tachycardia would be expected if the fetus were affected by maternal infection, but it is not present here.

A. Shuffling gait: A shuffling gait is a classic motor manifestation of Parkinson’s disease caused by rigidity and bradykinesia. Clients often take small, hesitant steps with reduced arm swing, which increases fall risk and affects mobility.

B. Resting tremor: Resting tremor, typically affecting the hands, fingers, or jaw, is one of the hallmark signs of Parkinson’s disease. It is most noticeable when the limb is at rest and decreases with voluntary movement.

C. Hypertension: Hypertension is not a direct manifestation of Parkinson’s disease. While autonomic dysfunction can occur, it more commonly causes orthostatic hypotension rather than elevated blood pressure.

D. Masklike facial expression: Reduced facial expressiveness, or “masklike” appearance, occurs due to rigidity of facial muscles. This is a characteristic symptom of Parkinson’s disease that affects nonverbal communication.

E. Diarrhea: Diarrhea is not typically associated with Parkinson’s disease. Gastrointestinal issues in Parkinson’s more commonly involve constipation due to slowed gastrointestinal motility.