A nurse is caring for a client who arrives at the emergency department and reports vomiting and diarrhea for the past 3 days. The client's serum potassium level is 2.8 mEq/L. Which of the following interventions should the nurse implement first?

Choice A Reason:

Applying lotion between the toes - Applying lotion between the toes can create a moist environment that may increase the risk of fungal infections. Lotion application should be done on the tops and bottoms of the feet, avoiding the spaces between the toes.

Choice B Reason:

Inspecting the feet every other day - Daily foot inspections are recommended for individuals with diabetes to identify any changes or abnormalities early and prevent potential complications.

Choice C Reason:

Soaking the feet twice a day - Excessive soaking of the feet can lead to maceration of the skin and increase the risk of infection, so it's generally not recommended. Regular washing with mild soap and water is sufficient for foot hygiene.

Choice D Reason

Trim toenails straight across When providing discharge teaching about foot care to a client with diabetes, the nurse should include information about proper foot care practices to prevent complications. Trimming toenails straight across is recommended to avoid ingrown toenails and potential injury. This reduces the risk of foot complications that can arise due to diabetes-related circulatory and neuropathic changes.

B. Open the first flap of the sterile package toward the nurse's body: When opening a sterile package, the nurse should open the first flap away from their body to prevent potential contamination from falling particles. This action helps maintain the sterility of the contents inside.

D. Place a surgical pack with a sterile drape on the work surface: Placing the surgical pack with a sterile drape on the work surface ensures that the sterile field is properly established. The sterile drape provides a clean and sterile area for the nurse to perform the dressing change.

Incorrect answers:

A. Select a work surface at the nurse's waist level: While it is important to select a work surface at an appropriate height for the nurse's comfort and ergonomics, the height of the work surface does not directly affect the maintenance of a sterile field.

C. Grasp 2.5 cm (1 in) of the outer edge to open the surgical wrap: When opening a sterile package, the nurse should grasp the inner edge of the sterile wrap to maintain the sterility of the contents. Grasping the outer edge can potentially lead to contamination of the sterile field.

E. Apply sterile gloves before opening the pack: Sterile gloves should be applied after the sterile field is established. Opening the sterile pack and setting up the sterile field should be done with clean (non-sterile) hands to avoid contaminating the contents. Once the sterile field is set up, the nurse can don sterile gloves before actually touching the sterile items.