The charge nurse in an emergency center is planning client care assignments for the staff. Which action may be safely delegated to the practical nurse (PN)?
Provide client with resources and discharge teaching
Educate the clients about prescribed dietary changes.
Establish blood pressure parameters for client monitoring
Reinforce diet teaching for discharge to home
The Correct Answer is D
Choice A Reason: This action requires assessment and evaluation skills, which are beyond the scope of practice of the PN. The nurse is responsible for providing client education and ensuring that the client understands the discharge instructions.
Choice B Reason: This action requires teaching and evaluation skills, which are beyond the scope of practice of the PN. The nurse is responsible for educating the clients about their prescribed dietary changes and assessing their learning needs and readiness.
Choice C Reason: This action requires critical thinking and decision-making skills, which are beyond the scope of practice of the PN. The nurse is responsible for establishing the blood pressure parameters for client monitoring and adjusting them as needed.
Choice D Reason: This action can be safely delegated to the PN, as it involves reinforcing previous teaching done by the nurse. The PN can review the diet information with the client and answer any questions they may have.
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Correct Answer is D
Explanation
Choice A Reason: Choosing to send another nurse who is more receptive is not a good option, as it may create
resentment and conflict among the staff. The older nurse may feel discriminated against or excluded, and the other nurse may feel burdened or pressured. The nurse manager should try to engage and motivate the older nurse to attend the in-service session, as it is important for her professional development and patient safety.
Choice B Reason: Asking the nurse why she thinks there is no need for an in-service program about these emergencies may sound confrontational or accusatory and may put the nurse on the defensive. The nurse manager should avoid making assumptions or judgments about the nurse's attitude or beliefs, and instead try to understand her perspective and address any barriers or misconceptions.
Choice C Reason: Informing the older nurse that inservice is not optional and her scheduled attendance is mandatory may be true, but it may also sound authoritarian or coercive, and may undermine the nurse's autonomy or dignity. The nurse-manager should avoid using threats or ultimatums, and instead try to explain the rationale and benefits of the inservice session, and solicit the nurse's input or feedback.
Choice D Reason: Encouraging the nurse to share her concerns and discuss ways to prepare for such emergencies is the best option, as it shows respect and empathy for the nurse, and fosters a collaborative and supportive
relationship. The nurse-manager should use active listening and open-ended questions, and provide relevant information and resources to help the nurse overcome her fears or doubts, and enhance her confidence and competence.
Correct Answer is A
Explanation
Choice A reason: This client may have an infection or sepsis, which are life-threatening complications of surgery. The nurse should assess the client's vital signs, wound appearance, and laboratory results, and notify the physician immediately.
Choice B reason: This client has a chest tube to drain the pleural fluid and re-expand the lung. The amount of drainage is within normal limits and does not indicate an emergency. The nurse should monitor the client's respiratory status, oxygen saturation, and chest tube function.
Choice C reason: This client has a gunshot wound that may have caused tissue damage and bleeding. The dressing with 2 cm-sized dark red drainage may indicate fresh bleeding, but it is not excessive. The nurse should check the dressing for signs of infection, change it as ordered, and report any changes to the physician.
Choice D reason: This client has a Jackson-Pratt drain to collect the fluid from the surgical site after a mastectomy. The amount of serosanguineous fluid is expected and does not indicate a problem. The nurse should empty and measure the drain output, record it, and report any abnormalities to the physician.
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