The nurse observes a practical nurse (PN) placing a client on the right side with the left leg bent in preparation for a lumbar puncture. Which action should the nurse implement?

Choice A reason: Consulting the palliative care team is an important action for the nurse to take, but not the first one. The palliative care team can provide holistic and compassionate care to the client and the family and help them cope with the end-of-life issues. However, the nurse should first obtain a do not resuscitate prescription from the healthcare provider to ensure that the client's wishes are respected and followed.

Choice B reason: Obtaining a do not resuscitate prescription is the first action for the nurse to take. The do not resuscitate prescription is a legal document that states that the client does not want any cardiopulmonary resuscitation or other life-sustaining interventions in the event of cardiac or respiratory arrest. The nurse should obtain the prescription from the healthcare provider and document it in the client's chart. The nurse should also inform the staff and the family about the prescription and its implications.

Choice C reason: Defining the term heroic measures is not the first action for the nurse to take. The term heroic measures is vague and subjective and may mean different things to different people. The nurse should clarify with the client and the family what they consider as heroic measures and what they want to avoid or accept. However, the nurse should first obtain a do not resuscitate prescription to ensure that the client's wishes are legally binding and clear.

Choice D reason: Coordinating a family conference is not the first action for the nurse to take. The family conference is a meeting where the client, the family, the healthcare provider, and the nurse can discuss the goals and plans of care and address any concerns or questions. The family conference can facilitate communication and decision-making and promote mutual understanding and support. However, the nurse should first obtain a do not resuscitate prescription to ensure that the client's wishes are honored and communicated.

Choice A reason: Assuming care of the client and assigning the PN to the care of a different client is not the best action the nurse should take. This may undermine the PN's confidence and competence and create resentment and conflict.

Choice B reason: Acknowledging that the PN has positioned the client safely and correctly is not the best action the nurse should take. This may reinforce the incorrect positioning and lead to complications during the lumbar puncture.

Choice C reason: Arranging for an unlicensed assistive personnel to assist the PN during the procedure is not the best action the nurse should take. This may not address the root cause of the incorrect positioning and may not improve the PN's skills and knowledge.

Choice D reason: Demonstrating to the PN how to position the client more effectively for the procedure is the best action the nurse should take. This will correct the error and provide the PN with feedback and guidance on how to perform the task correctly in the future.