A nurse is admitting a client who has sickle cell anemia. Which of the following manifestations should the nurse expect with this condition?(Select All that Apply.)

A. While it is important to address concerns about impairment, confronting the nurse directly can be counterproductive and may escalate the situation. It is essential to approach the situation with caution and follow established protocols for dealing with suspected substance impairment.
B. While gathering observations from colleagues may seem reasonable, it can create a culture of gossip and may violate confidentiality. This approach can also lead to misinformation and should not be the first step in addressing a serious concern about a colleague's safety and well-being.
C. Documenting observations is important, but it should not be the sole action taken at this point. Communicating with the personnel department is part of the process if the situation escalates, but immediate action is necessary to ensure patient safety.
D. This option is the most appropriate initial action. By closely monitoring the nurse’s behavior, the manager can gather more information before taking further steps. This approach allows for the collection of objective data and ensures patient safety while avoiding premature accusations.

A. This task is appropriate for UAP, as it involves basic hygiene care. UAP can assist with routine oral care
B. Assisting with repositioning is a basic care activity that UAP can perform. This helps prevent pressure ulcers and maintains client comfort, and it does not require advanced clinical skills.
C. Administering IV fluids or medications requires specialized training and knowledge of nursing assessments, potential complications, and monitoring. This task should only be performed by a licensed nurse, not by UAP.
D. UAP can document basic measurements such as urine output. This is a straightforward task that does not require clinical judgment, but the UAP should understand how to accurately measure and record this information.
E. While UAP can observe and report general changes, monitoring for clinical indications of dehydration requires nursing assessment skills and judgment. This task should be performed by an RN, as it involves interpreting signs and symptoms.
F. UAP can weigh clients, but the assessment of weight trends requires clinical judgment and interpretation of data. The RN should evaluate and interpret this information to determine its significance in the client's care.