The busy emergency department at a hospital has experienced a sharp increase in negative outcomes among clients with heart conditions in the past month. Which of the following actions should the nursing staff take to improve client outcomes?

A. While low ferritin levels can indicate iron deficiency anemia, sickle cell anemia primarily involves the production of abnormal hemoglobin rather than iron deficiency. Fatigue in sickle cell anemia is more closely related to the effects of the disease itself, including chronic hemolysis and decreased red blood cell survival.
B. Sickle cell anemia is not classified as an autoimmune disease; it is a genetic disorder caused by a mutation in the hemoglobin gene. While individuals with sickle cell anemia may have increased susceptibility to infections, the fatigue they experience is not due to an autoimmune process.
C. Sickle cell anemia leads to chronic hemolytic anemia, meaning the abnormal sickle-shaped red blood cells break down more quickly than normal red blood cells. This results in a lower overall red blood cell count (anemia), which can cause fatigue and weakness due to reduced oxygen-carrying capacity in the blood.
D. While gastrointestinal bleeding can lead to fatigue due to blood loss and subsequent anemia, it is not a direct consequence of sickle cell anemia. If the client had experienced a gastrointestinal bleed, it would typically need to be evaluated independently of their sickle cell disease.

A. While LPNs can perform some assessments, the charge nurse should assign this task to an RN. Assessing hydration status requires critical thinking and a comprehensive understanding of the client's overall clinical condition, which typically falls within the RN’s scope of practice.
B. Administering medications, including antibiotics like metronidazole, is within the scope of practice for LPNs. As long as the LPN is competent in administering medications and there are no specific contraindications for the client, this task can be appropriately assigned.
C. This task involves critical thinking and comprehensive analysis of the client's medical history, which is typically conducted by an RN. While LPNs may review aspects of the medical history, the charge nurse should assign more complex evaluations and assessments to RNs.
D. While LPNs can provide some patient education, explaining the rationale behind specific tests, especially in the context of complex infections, typically requires the knowledge and expertise of an RN. This task may involve more detailed clinical reasoning and the ability to address specific questions and concerns that the client or family may have.