A nurse is caring for a client who is postoperative and is receiving opioid analgesics. Which of the following findings should the nurse report to the provider?

A. Reposition the client every 3 hr: This is insufficient. The standard of care for a client at risk is repositioning at least every 2 hours while in bed and every 1 hour while sitting in a chair to ensure adequate blood flow to compressed tissues.

B. Place the client on a donut-shaped cushion: A donut-shaped cushion is not recommended for preventing pressure ulcers. It can increase pressure on the tissue, leading to further complications. A more effective intervention is use of pressure-redistribution surfaces.

C. Elevate the head of the bed to 45°: Elevating the head of the bed can increase pressure on the sacral area and can be uncomfortable for clients with mobility and incontinence issues. The head of the bed should be elevated only when necessary for breathing or comfort, not as a routine practice.

D. Request a consult with a registered dietitian: The client has decreased intake and may be at risk for malnutrition or dehydration. A dietitian’s input is essential to assess nutritional needs, especially for a client with diabetes and decreased mobility, to ensure proper healing and management.

E. Provide a support pressure-redistribution surface: A support pressure-redistribution surface is crucial for this client to reduce the risk of pressure ulcers. These surfaces help alleviate pressure on bony prominences and distribute the body weight evenly to prevent tissue damage.

F. Perform a skin risk assessment weekly: Skin risk assessments should be done more frequently than weekly, especially for a client with decreased mobility, incontinence, and diabetes. Daily or at least twice-weekly assessments are needed to monitor for early signs of skin breakdown.

G. Use a moisture barrier ointment after cleaning the client's skin: Using a moisture barrier ointment is essential for protecting the skin, especially since the client has urinary and fecal incontinence. This will help prevent skin irritation and breakdown caused by exposure to moisture.

A. The Emergency Medical Treatment and Active Labor Act requires that emergency care be provided regardless of the client’s behavior, as long as the client is seeking treatment for an emergency medical condition.

B. EMTALA requires that a client receive a medical screening and stabilization before being transferred, regardless of whether the condition is terminal. A terminal diagnosis does not justify transferring a client without stabilization first.

C. EMTALA prohibits discrimination based on a client’s ability to pay. A client cannot be transferred or discharged from an emergency department based on their inability to pay for services.

D. EMTALA requires that a client must be stabilized before being transferred to another facility. This ensures that the client is not placed at risk by the transfer, and the new facility is prepared to manage their care appropriately.