A nurse is caring for residents at a long-term care facility following a tornado. Which of the following tasks should the nurse delegate to an assistive personnel?

A) Determine which clients need priority medical treatment: This task requires clinical judgment and assessment skills beyond the scope of practice for assistive personnel. Nurses are responsible for assessing clients' needs during emergencies and determining priority for medical treatment based on the severity of their conditions.

B) Answer questions from area residents who have health concerns: While it's important to provide information and support to those affected by the tornado, answering questions about health concerns requires knowledge and expertise in healthcare that is typically within the nurse's scope of practice. Nurses should address inquiries and provide education to ensure the well-being of the community.

C) Perform CPR for a client who is not breathing: This task can be delegated to assistive personnel if they are trained and competent in CPR. In emergencies such as cardiac arrest, prompt initiation of CPR can be life-saving. However, it's crucial to ensure that the assistive personnel are properly trained and certified in CPR before delegating this task.

D) Complete distal capillary refill checks for a client who has an open leg wound: While assessing capillary refill is an important aspect of wound care, performing this task for a client with an open leg wound requires specialized knowledge and skills in wound assessment and management. It falls within the scope of nursing practice and should not be delegated to assistive personnel.

A) Select the appropriate dressing:

Choosing the appropriate dressing is an essential step in the process of changing a wound dressing. However, before selecting a dressing, the nurse should first review the available dressing types to ensure that the choice is based on a comprehensive understanding of the client's wound characteristics, such as size, depth, exudate level, and presence of infection. Jumping straight to selecting a dressing without reviewing available options may result in choosing an inadequate or inappropriate dressing for the client's specific wound care needs.

B) Review available dressing types:

This is the most appropriate initial step in the process of changing a wound dressing. Before proceeding with the dressing change, the nurse should assess the client's wound and review the available dressing types to determine which one is most suitable. Factors to consider include the wound's characteristics, such as size, depth, and exudate level, as well as any specific requirements based on the stage of the pressure ulcer and the client's overall condition. Reviewing available dressing types ensures that the nurse makes an informed decision and selects the most appropriate dressing for promoting wound healing and preventing complications.

C) Document the dressing change:

Documentation is an essential aspect of wound care, as it provides a record of the client's progress, the interventions performed, and the client's response to treatment. While documenting the dressing change is important, it should occur after the dressing change itself. Documenting before completing the dressing change could lead to incomplete or inaccurate documentation, as the nurse may need to record details about the wound's appearance, the type of dressing used, and any observations made during the procedure.

D) Change the dressing:

Changing the dressing is a necessary step in the wound care process, but it should not be the first action taken without assessing the wound and reviewing available dressing options. Proceeding directly to changing the dressing without considering the client's specific wound care needs and available dressing types may result in suboptimal wound management and compromise the client's healing process.