The nurse assesses patients to determine their risk for healthcare acquired infections. Which hospitalized patient would the nurse consider most at risk for developing this type of infection?

• Client's hearing deficit: The client’s hearing loss poses a significant barrier to effective communication. Without a hearing aid, the client may have difficulty understanding verbal communication, leading to misunderstandings.

• Volume of the client's television: A loud television creates distracting background noise, making it challenging for the nurse to communicate clearly. This can hinder the client's ability to hear and comprehend important information during interactions.

• Numerous visitors in the client's room: Having multiple visitors can create distractions and noise, making it difficult for the nurse to effectively communicate with the client. Visitors may also divert the client’s attention, impacting their ability to engage in discussions with the nurse.

• Increase in pain after ambulation: The reported increase in pain can affect the client’s focus and engagement in communication. When experiencing pain, the client may find it challenging to concentrate on conversations, which impacts the overall effectiveness of communication with the nurse.

• Adverse effects of opioid analgesic: While not explicitly mentioned in the initial scenario, opioid analgesics can cause side effects such as sedation and confusion, which may impair the client’s ability to communicate effectively. This could lead to misunderstandings and miscommunication.

• Using earphones while listening to music: This factor, if present, would create a barrier to communication, as it would prevent the client from hearing the nurse's questions or instructions. However, it was not explicitly stated in the scenario.

A. Bathe a client who had an amputation 2 days ago: This task can be delegated to assistive personnel (AP). APs are trained to assist with activities of daily living, including bathing, under the supervision of nursing staff. The nurse should ensure that the AP is aware of any special considerations related to the client's recent amputation.

B. Review a low-sodium diet for a client who has hypertension: This task should not be delegated to APs, as it requires nursing knowledge and understanding to educate the client effectively. Discussing dietary modifications involves assessing the client's understanding and providing education, which falls under the nursing scope of practice.

C. Feed a client who had a stroke 3 months ago: This task can be delegated to APs, provided that the client is stable and the AP has been trained to assist clients with feeding. However, the nurse should assess the client's swallowing ability and any specific precautions related to the stroke before delegating this task.

D. Explain oral hygiene to a client receiving chemotherapy: This task should not be delegated to APs because it involves providing specific education and instructions regarding oral care, which requires nursing judgment and knowledge about the implications of chemotherapy on oral health.

E. Assist a client to ambulate using a gait belt: This task can be delegated to APs. Assisting with ambulation is within the scope of practice for APs, especially when proper techniques and safety measures, such as using a gait belt, are followed. The nurse should ensure that the AP has received appropriate training to assist with ambulation safely.