A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?

A. CD4 T cell count 180 cells/mm3: In a client with HIV, monitoring the CD4 T cell count is crucial for assessing immune function and determining the progression of the disease. A CD4 T cell count of less than 200 cells/mm3 indicates severe immunosuppression and an increased risk of opportunistic infections, making it the priority laboratory value to monitor in this client.
B. Platelets 150,000/mm3: While platelet count is important for assessing clotting function, it is not the priority laboratory value in a client with HIV. Thrombocytopenia can occur in HIV but is often secondary to other factors such as medication side effects or opportunistic infections. However, a platelet count within the normal range of 150,000/mm3 is reassuring and does not require immediate intervention.
C. WBC 5000 mm3: White blood cell (WBC) count is essential for assessing overall immune function, but it is not the priority laboratory value in a client with HIV. A WBC count of 5000 mm3 is within the normal range and does not require urgent attention.
D. Positive Western blot test: While a positive Western blot test confirms HIV infection, it does not provide information about the client's current immune status or the need for immediate intervention. Confirmatory tests such as Western blot are important for diagnosis, but they do not provide ongoing monitoring of disease progression or immune function.

A. Requesting an order for an antiemetic may be necessary if the client continues to experience nausea, but it is not the first action the nurse should take. Before administering medication, the nurse should assess the client's vital signs and overall condition to determine the appropriate intervention.
B. While a dietitian consult may be beneficial to address the client's nutritional needs, it is not the first action the nurse should take in response to the client's symptoms of nausea and weakness. Assessing the client's vital signs and condition should be the priority.
C. Suggesting that the client rests before eating the meal may be helpful, but it does not address the underlying cause of the client's symptoms. The nurse should first assess the client's vital signs to determine the severity of the symptoms and any potential complications.
D. Checking the client's vital signs is the first action the nurse should take in response to the client's symptoms of nausea and weakness. Vital signs, including blood pressure, heart rate, respiratory rate, and temperature, can provide valuable information about the client's hemodynamic status and help identify any potential complications, such as dehydration or worsening heart failure. Based on the vital signs assessment, the nurse can then implement appropriate interventions, such as notifying the healthcare provider or providing symptomatic relief.