A nurse in the emergency department is assessing a preschool-age child who has bruises on both arms and a spiral fracture of the left ulna. The child's parent tells the nurse that the child tripped over some toys and fell down. Which of the following actions should the nurse take?

Choice A reason: The client needs to have someone come in to help her bathe at home is not a data that supports a referral for a social worker, as it is a need for home health care or personal care assistance. The nurse should refer the client to a home health agency or a community resource that provides such services.

Choice B reason: The client needs to arrange financial resources to purchase equipment is a data that supports a referral for a social worker, as it is a need for financial assistance or counseling. The nurse should refer the client to a social worker who can help the client access available resources, such as insurance, grants, or loans, to cover the cost of the equipment.

Choice C reason: The client needs to have someone bring oxygen tanks and equipment to her home is not a data that supports a referral for a social worker, as it is a need for oxygen therapy or equipment delivery. The nurse should refer the client to a respiratory therapist or a durable medical equipment company that can provide the oxygen and the equipment.

Choice D reason: The client needs to have range-of-motion exercises to assist with ambulation is not a data that supports a referral for a social worker, as it is a need for physical therapy or rehabilitation. The nurse should refer the client to a physical therapist or a rehabilitation center that can provide the exercises and the guidance.

Choice A reason: A client who has gestational diabetes and is receiving biweekly nonstress tests is incorrect. Gestational diabetes requires monitoring of maternal blood glucose levels and fetal well-being. Nonstress tests are a common method of assessing fetal well-being in pregnancies complicated by conditions such as gestational diabetes. Nurses caring for clients with gestational diabetes need to understand the management of blood glucose levels, dietary considerations, insulin administration if needed, and fetal monitoring techniques. This requires obstetrical-specific knowledge and expertise.

Choice B reason: A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump is correct. This client is postoperative following a Cesarean section and is likely in need of pain management through a PCA pump. Postoperative care after a Cesarean section involves monitoring for signs of complications such as infection, bleeding, and wound healing, as well as managing pain effectively. While nurses with medical-surgical experience may be familiar with PCA pumps, the postoperative care of a cesarean section client involves obstetrical-specific considerations such as uterine monitoring, assessment of lochia (vaginal discharge after childbirth), and breastfeeding support.

Choice C reason: A client who is at 32 weeks of gestation and has premature rupture of membranes is not an appropriate assignment for the RN who has floated from a medical-surgical unit, as it involves a high-risk pregnancy that needs close monitoring and intervention to prevent preterm labor and infection. The charge nurse should assign this client to an RN who is competent in the obstetrical unit.

Choice D reason: A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor is not an appropriate assignment for the RN who has floated from a medical-surgical unit, as it involves a complex and potentially life-threatening condition that requires frequent assessment and intervention to prevent eclampsia, hemorrhage, and fetal distress. The charge nurse should assign this client to an RN who is proficient in the obstetrical unit.