A nurse is assisting a postoperative client.

The client is alert and oriented to person, place, and time, and reports incisional pain of 9 on a scale of 1 to 10. Morphine 8 mg was administered subcutaneously as prescribed at 0900.

The client is now sleeping and is difficult to arouse.

Pupils are 3 mm, equal and reactive to light.

Temperature is 37.5 C (99.5°), respirations are 10/min, and pulse oximetry is 87% on room air.

Which documentation in the client’s medical record requires further action by the nurse?

Choice A rationale
Discussing facility policies with coworkers. While understanding facility policies is important, it does not necessarily contribute to maintaining clinical competence.
Choice B rationale
Attending a professional conference. This is the correct answer. Professional conferences often provide opportunities for continuing education, learning about the latest research and best practices, and networking with other professionals in the field.
Choice C rationale
Joining a nurses’ union. While a union can provide support and advocacy for nurses, joining a union does not directly maintain clinical competence.
Choice D rationale
Removing expired supplies from the storage area. This is an important task for maintaining a safe and effective work environment, but it does not contribute to maintaining clinical competence.

Choice A rationale
This statement accurately explains what adhesions are. Adhesions are areas of scar tissue that form between organs or tissues in the abdomen. They often form after surgery and can cause some of these loops to stick together, resulting in abdominal pain and occasionally obstruction (blockages) in the gut. In the context of a small bowel obstruction, adhesions can cause the intestines to twist or kink, similar to how a garden hose can become kinked.
Choice B rationale
While this statement may be intended to reassure the client, it does not provide the client with the information they are seeking about what adhesions are and how they are causing the blockage.
Choice C rationale
Offering to provide reading materials about the procedure does not directly answer the client’s question about what adhesions are. It may also be overwhelming for the client who is already anxious and preparing for emergency surgery.
Choice D rationale
This statement minimizes the client’s concerns and does not provide the necessary information about what adhesions are and how they are causing the blockage.