A nurse is caring for four clients and is delegating tasks to an assistive personnel (AP). Which of the following tasks should the nurse plan to have the AP perform?
Provide postmortem care for a client who died 1 hr ago.
Reinforce discharge instructions with a client who is 2 days postoperative following an appendectomy.
Interpret deviations in a client's vital signs.
Insert an NG tube for a client who has difficulty eating.
The Correct Answer is A
A. Providing postmortem care is a task that can be delegated to assistive personnel, as it involves following established protocols and does not require clinical judgment.
B. Reinforcing discharge instructions requires clinical knowledge and assessment, making it inappropriate for delegation to an AP.
C. Interpreting deviations in a client's vital signs necessitates nursing judgment and clinical expertise, which an AP does not possess.
D. Inserting an NG tube is a skilled nursing procedure that requires assessment and decision-making, thus it should not be delegated to an AP.
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Correct Answer is D
Explanation
A. QD (every day) is not an approved abbreviation due to the potential for misinterpretation, so it should not be used.
B. HS (at bedtime) is also not recommended as it can be confused with "half-strength," so it is not an approved abbreviation.
C. SQ (subcutaneous) is not commonly used in current practice as abbreviations may lead to errors; the term should be written out as "subcut" or "subcutaneously."
D. PO (by mouth) is an accepted and approved abbreviation used to indicate that a medication is to be taken orally, making it the correct choice for inclusion in the in-service.
Correct Answer is D
Explanation
A. Postoperative emesis is a common occurrence and may not be critical unless it persists or is accompanied by other concerning signs.
B. While an 8 out of 10 pain level is significant, it can be managed with appropriate interventions and does not indicate an immediate complication.
C. Urinary output of 30 mL over 1 hour is low but does not necessarily indicate a critical condition that requires immediate intervention.
D. Mottling in the affected leg is a serious finding that may indicate compromised circulation or a thromboembolic event, making it the priority for reporting to the provider.