A charge nurse is observing a staff nurse performing a wound irrigation for a client who has a pressure injury. Which of the following actions by the staff nurse indicates an understanding of the procedure?

A. Albumin 3.1 g/dL (3.5 to 5.0 g/dL)

Albumin is a protein produced by the liver, and its levels are commonly used as an indicator of nutritional status, particularly protein status. In clients with liver dysfunction and receiving continuous tube feeding, a low albumin level indicates protein deficiency. Albumin plays a crucial role in maintaining oncotic pressure in the blood vessels, and decreased levels can lead to fluid shifts and edema, among other complications.

B. Transferrin 400 mg/dL (250 to 380 mg/dL):

Transferrin is a protein involved in iron transport. While high transferrin levels may indicate iron deficiency, they do not directly reflect protein deficiency.

C. Uric acid 2.3 mg/dL (2.7 to 7.3 mg/dL):

Uric acid is a waste product of metabolism. Low uric acid levels are not indicative of protein deficiency; instead, they may be seen in conditions such as liver dysfunction or decreased production of uric acid.

D. Total iron-binding capacity 488 mcg/dL (250 to 460 mcg/dL):

Total iron-binding capacity measures the amount of iron that can be bound by transferrin. Elevated total iron-binding capacity may indicate iron deficiency, but it does not directly reflect protein deficiency.

A. Social worker:

While social workers play a vital role in addressing psychosocial needs and connecting clients with community resources, they typically do not have the specialized skills or training to address the physical limitations associated with feeding difficulties due to rheumatoid arthritis. Therefore, a referral to a social worker may not directly address the client's need for assistance with feeding.

B. Occupational therapist

Occupational therapists specialize in helping individuals regain or maintain independence in performing activities of daily living (ADLs), including feeding oneself. In the case of a client with severe rheumatoid arthritis in her hands who is unable to feed herself, an occupational therapist can assess the client's abilities, provide interventions such as adaptive equipment or techniques to facilitate feeding, and offer strategies to improve hand function and joint mobility. They can also collaborate with the client and other members of the healthcare team to develop a customized plan of care to address the client's specific needs and goals related to feeding and self-care.

C. Physician assistant:

Physician assistants work closely with physicians to provide medical care and may be involved in diagnosing and managing various health conditions. However, they do not typically provide specialized rehabilitation services or interventions related to activities of daily living such as feeding. Therefore, a referral to a physician assistant may not address the client's specific need for occupational therapy services.

D. Physical therapist:

Physical therapists specialize in restoring mobility, strength, and function, primarily focusing on gross motor skills and movement patterns. While physical therapists may address certain aspects of hand function and mobility, they do not specialize in activities of daily living such as feeding. Therefore, a referral to a physical therapist may not directly address the client's need for assistance with feeding due to severe rheumatoid arthritis in her hands.