A nurse asks the assistive personnel (AP) to take a specimen to the laboratory and the AP refuses. Which of the following actions should the nurse take?

Complete an incident report.

Take the specimen to the laboratory.

Report the AP to the charge nurse.

Ask the AP about her concerns with the assignment.

Answer and Explanation

The Correct Answer is D

A.   Completing an incident report may be necessary if the refusal could potentially impact patient care or if there are policies or procedures in place that require documenting such incidents. It helps to document the details of the refusal and any subsequent actions taken.
B.   If the AP refuses to take the specimen, the nurse may need to take responsibility for ensuring the specimen is delivered to the laboratory promptly. This ensures that patient care activities are not delayed and that necessary diagnostic tests are performed in a timely manner.
C.   Reporting the refusal to the charge nurse or supervisor is appropriate, especially if there are concerns about the AP's behavior or if it is part of the facility's policy to escalate such incidents. The charge nurse can then address the situation and determine the appropriate course of action.

D.   Communicating with the AP to understand their concerns is essential. It allows the nurse to clarify any misunderstandings, address any issues or barriers the AP may have, and potentially resolve the situation collaboratively. It's important to listen to the AP's perspective and provide clarification or reassurance if needed.

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Correct Answer is D

Explanation

A. Hypophosphatemia refers to low levels of phosphate in the blood. In prerenal AKI, phosphate levels are typically normal or even elevated due to reduced kidney function and impaired phosphate excretion. Therefore, hypophosphatemia is not expected in prerenal AKI.
B. Hypernatremia refers to high levels of sodium in the blood. In prerenal AKI, sodium levels can be elevated due to reduced kidney function and impaired ability to excrete sodium. This occurs because the kidneys play a crucial role in regulating sodium balance. Therefore, hypernatremia is a possible electrolyte imbalance in prerenal AKI.
C. Hypercalcemia refers to high levels of calcium in the blood. In prerenal AKI, calcium levels are usually normal or decreased due to various factors, including reduced renal excretion of calcium. Therefore, hypercalcemia is not typically seen in prerenal AKI.
D. Hyperkalemia refers to high levels of potassium in the blood. In prerenal AKI, hyperkalemia is a common electrolyte imbalance. Normally, the kidneys play a critical role in potassium excretion. Reduced kidney function in prerenal AKI can lead to impaired potassium excretion, resulting in elevated potassium levels in the blood.

A. Potassium B. Calcium C. Albumin D. Sodium

Correct Answer is C

Explanation

A. Potassium levels are important for assessing electrolyte balance and are not directly indicative of protein intake or synthesis.
B. Calcium levels are important for bone health, nerve function, and muscle contraction. They are not directly indicative of protein intake or synthesis.
C. Albumin is a plasma protein that reflects the body's nutritional status and liver function. It has a relatively long half-life (approximately 20 days), making it a useful marker for assessing protein intake and synthesis over time. Low albumin levels can indicate malnutrition, liver disease, or other conditions affecting protein metabolism.
D. Sodium levels are important for fluid balance and nerve function. They are not directly indicative of protein intake or synthesis.

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A nurse asks the assistive personnel (AP) to take a specimen to the laboratory and the AP refuses. Which of the following actions should the nurse take?

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