A nurse is developing a care plan for a client who is in Buck’s traction and is scheduled for surgery for a fractured femur of the right leg.
Which of the following interventions should the nurse delegate to an assistive personnel?

The correct answer is choice B. Instruct the client to notify the provider if diarrhea develops.

Choice A rationale:

Infusing the medication over 10 minutes is incorrect because penicillin G should typically be infused over 15-30 minutes to ensure proper administration and reduce the risk of adverse reactions.

Choice B rationale:

Instructing the client to notify the provider if diarrhea develops is correct because diarrhea can be a sign of a serious side effect, such as antibiotic-associated colitis, which requires prompt medical attention.

Choice C rationale:

Refrigerating the medication after reconstitution is not necessary for penicillin G. This instruction is more relevant for other medications that require refrigeration to maintain stability.

Choice D rationale:

Checking the client for a sulfa allergy is not relevant to penicillin G, as it is not a sulfa drug. This action would be more appropriate for medications containing sulfonamides.

. Taking a hot shower in the morning can help decrease stiffness and improve joint mobility for people with rheumatoid arthritis. This is one of the self-management strategies that can reduce pain and disability.

Choice A is wrong because applying cold packs directly on the skin of the affected joints can cause vasoconstriction and increase inflammation.

Cold therapy should be used with caution and with a barrier between the skin and the ice pack.

Choice B is wrong because biological response modifiers are not used to prevent infection, but to reduce inflammation and slow down joint damage in rheumatoid arthritis.

These medications can actually increase the risk of infection by suppressing the immune system.

Choice D is wrong because clustering physical activities during the day can cause fatigue and joint stress for people with rheumatoid arthritis.

It is better to pace activities throughout the day and take frequent breaks to rest the joints.

Normal ranges for rheumatoid arthritis are based on the disease activity score (DAS), which measures the number of swollen and tender joints, the level of inflammation in the blood, and the patient’s global assessment of health. A DAS below 2.6 indicates remission, a DAS between 2.6 and 3.2 indicates low disease activity, a DAS between 3.2 and 5.1 indicates moderate disease activity, and a DAS above 5.1 indicates high disease activity.