A nurse is caring for a client who is on isolation precautions. Which of the following pieces of personal protective equipment should the nurse remove first?

Rationale:

A. Removing an NG tube: Removing a nasogastric tube is a task that can be safely delegated to a licensed practical nurse (LPN) under appropriate supervision, as it is considered a stable, routine procedure that does not require complex assessment.

B. Administering a subcutaneous insulin injection: LPNs are trained and authorized to administer subcutaneous injections, including insulin, as long as the client's condition is stable and the dose is clearly prescribed.

C. Providing discharge teaching about home IV medication therapy: Discharge education involving IV therapy requires comprehensive teaching, clinical judgment, and evaluation of understanding, which falls within the scope of practice of a registered nurse (RN).

D. Collecting a sputum culture: Collecting a sputum specimen is a basic nursing task that can be performed by an LPN or even by trained assistive personnel, depending on facility policy. It does not require the expertise of an RN.

Rationale:

A. "Discontinue the medication. I will ask your provider for another antibiotic.": Calf pain in a client taking ciprofloxacin may indicate tendinitis or even tendon rupture, a serious adverse effect associated with fluoroquinolones. The nurse should advise discontinuation of the drug and alert the provider immediately to prevent permanent damage.

B. "That reaction means your dose is too high. Cut the pill in half.": Reducing the dose without provider approval is unsafe and does not address the underlying risk of tendon injury. Ciprofloxacin-related tendinopathy is not dose-dependent and requires immediate discontinuation.

C. "Continue to take the medication. Calf pain is a minor reaction that will resolve itself.": Calf pain during ciprofloxacin therapy should never be dismissed as minor, since it may signal tendon inflammation or rupture.

D. “This is an allergic reaction. Take the medication with an antihistamine.": Tendon-related adverse effects are not allergic reactions and will not respond to antihistamines. Misclassifying the symptom as an allergy delays the proper intervention and increases the risk of irreversible tendon damage.