A nurse is assessing a child who has new onset varicella. Which of the following findings should the nurse expect?

Choice A reason: Checking the skin after 15 minutes is appropriate to prevent tissue injury such as frostbite. Ice therapy should be monitored closely to ensure safety and effectiveness.

Choice B reason: Applying ice directly to the skin is unsafe because it can cause frostbite and tissue damage. Ice should always be wrapped in a barrier such as a towel.

Choice C reason: Ice therapy decreases blood flow by causing vasoconstriction, which reduces swelling and inflammation. Saying it increases blood flow is incorrect.

Choice D reason: Heat therapy should not immediately follow ice therapy. Heat increases blood flow and swelling, which is contraindicated in the acute phase of injury.

Choice A reason: Reporting to the nurse manager is the appropriate and required action. Chemical impairment poses a serious risk to patient safety, and immediate reporting ensures that the situation is addressed according to institutional policy and regulatory standards. This is the correct answer because it prioritizes patient safety and professional accountability.

Choice B reason: Setting up a time to meet with the nurse is inappropriate because it delays intervention and places responsibility on the reporting nurse rather than the manager. It also risks confrontation without proper support.

Choice C reason: Assuming care of the impaired nurse’s clients may temporarily protect patients but does not address the root issue. It also places undue burden on the reporting nurse and fails to follow proper protocol.

Choice D reason: Asking another staff nurse to confirm the suspicion is not appropriate. It risks gossip, breaches confidentiality, and delays necessary intervention. The nurse should report directly to the manager rather than seeking peer validation.