A nurse is caring for a client who is to undergo a subtotal thyroidectomy. Which of the following items should the nurse place at the client’s bedside?

Rationale:

A. Give the dose of medication in the infant's bottle: Placing nystatin in a bottle may result in incomplete dosing, as the infant may not consume the full amount. This method also limits the medication's contact time with the affected mucosa, reducing its effectiveness.

B. Educate the caregiver to avoid breastfeeding: Breastfeeding should not be avoided unless the mother has signs of candidiasis on the breast. Instead, both mother and infant should be treated simultaneously if either shows symptoms to prevent reinfection.

C. Administer the medication before the infant's feeding: Administering nystatin before feeding may cause the medication to be washed away by milk, decreasing mucosal contact time. It is generally recommended after feeding to ensure prolonged exposure to the mucosa.

D. Distribute the medication on the infant's oral mucosa: Applying the suspension directly to the affected areas allows the antifungal to coat the mucosa thoroughly, maximizing effectiveness. It is the preferred method to treat oral candidiasis in infants.

Rationale:

A. Plan a time at the end of the shift to document nursing interventions: Delaying documentation until the end of the shift risks forgetting important details and compromises accuracy. Best practice is to document interventions and observations as close to the time of care as possible to ensure timely, complete records.

B. Delegate collection of vital signs to the assistive personnel on the team: Delegating routine tasks like vital sign collection allows the nurse to focus on complex responsibilities requiring clinical judgment. This supports time efficiency while ensuring client care needs are still met promptly.

C. Make a priority to-do list at the beginning of the shift: Creating a task list based on client acuity and scheduled interventions helps the nurse remain focused and organized. Prioritizing tasks early supports decision-making and improves workflow throughout the shift.

D. Keep track of how long it takes to complete certain tasks: Monitoring time spent on different tasks helps identify inefficiencies and allows the nurse to adjust workflow. This self-awareness supports better time management in future shifts.

E. Complete activities with one client before moving to another client: Focusing on one client at a time may lead to inefficiencies and delayed care for other clients. Nurses should cluster care and prioritize based on client needs, rather than adhering rigidly to completing all care for one client before moving on.