The nurse is assisting with a lumbar puncture on a client. During the procedure, a code is called for another client on the unit who is experiencing respiratory arrest. Which action should the nurse take?

Choice A reason: Observing the nurse for jaundice and icterus sclera is not the best action for the nurse-manager to take. These are signs of liver damage that may occur in the later stages of HVA infection. The nurse-manager should not rely on the physical appearance of the nurse to diagnose or rule out HVA. The nurse-manager should also respect the privacy and dignity of the nurse and not make any assumptions based on the skin or eye color.

Choice B reason: Reviewing the immunization status of all unit employees is an important action for the nurse-manager to take, but not the best one. The nurse-manager should ensure that all the staff are vaccinated against HVA or have received immune globulin if exposed. However, this action does not address the immediate needs and concerns of the nurse who is symptomatic and may be infected. The nurse-manager should also consider the possibility of other causes of the nurse's symptoms besides HVA.

Choice C reason: Referring the nurse to employee health for serological testing is the best action for the nurse-manager to take. The nurse-manager should facilitate the prompt and accurate diagnosis and treatment of the nurse who is symptomatic and may have HVA. The nurse-manager should also follow the infection control and reporting protocols of the facility and the health department. The nurse-manager should also provide support and counseling to the nurse and the staff.

Choice D reason: Posting an employee notice of the outbreak of HVA on the unit is not the best action for the nurse-manager to take. The nurse-manager should inform and educate the staff about the risk and prevention of HVA, but not in a way that may cause panic or stigma. The nurse-manager should also protect the confidentiality and rights of the nurse and the UAP who are diagnosed with HVA. The nurse-manager should also consult with the infection control and quality improvement teams before posting any notice.

Choice A reason: Providing revised procedural updates through additional nursing staff education programs is not the best action for the nurse manager to take. The nurse manager should first evaluate the effectiveness of the current policies and education programs before implementing any changes. The nurse manager should also involve the nursing staff in the process of revising the policies and education programs.

Choice B reason: Examining medication administration data to determine use of new policy by nursing staff is the best action for the nurse manager to take. The nurse manager should analyze the data to identify the types, causes, and frequency of medication errors and compare them with the previous data. The nurse manager should also assess the compliance and feedback of the nursing staff regarding the new policies. This will help the nurse manager to identify the gaps and barriers in the implementation of the new policies and plan appropriate interventions.

Choice C reason: Investigating identified procedural variances in medication administration with nursing staff is an important action for the nurse manager to take, but not the best one. The nurse manager should first examine the medication administration data to determine the extent and nature of the procedural variances. The nurse manager should then investigate the specific cases of variances with the nursing staff and provide constructive feedback and guidance.

Choice D reason: Determining changes in procedure needed to reduce the frequency of medication errors is a desirable outcome for the nurse manager, but not the best action to take. The nurse manager should first examine the medication administration data and investigate the procedural variances before making any changes in the procedure. The nurse manager should also consult with the healthcare provider, the pharmacist, and the quality improvement team to ensure that the changes are evidence-based and feasible.