A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?

Choice A rationale:

Reporting a near-miss using the facility’s recommended protocol and correcting the error on the MAR is the appropriate action. A “near-miss” in healthcare is a situation where an error could have happened, but didn’t, either by chance or timely intervention. It’s crucial to report these incidents as they provide valuable information for risk management and quality improvement. By analyzing near-misses, healthcare facilities can identify potential hazards and take preventive measures to ensure patient safety. Correcting the error on the MAR is also important to prevent the same mistake from happening in the future.

Choice B rationale:

Reporting the near-miss to the next shift before the next dose is due is not the best course of action. While it’s important to communicate any potential issues to the next shift, it’s more crucial to report the incident immediately using the facility’s recommended protocol. This allows for a timely investigation and corrective action. Waiting until the next shift could delay these processes and potentially put patient safety at risk.

Choice C rationale:

Correcting the MAR error but saying nothing because nothing happened is not an appropriate response. Even though the error did not result in any harm, it’s still important to report it. Near-misses are often indicators of underlying system issues that need to be addressed. By not reporting the incident, the opportunity to improve patient safety and prevent future errors is lost.

Choice D rationale:

Notifying the pharmacy about the error they almost caused is not the most appropriate action. While it’s important to communicate with the pharmacy if they were involved in the error, the first step should always be to report the near-miss using the facility’s recommended protocol. This ensures that the incident is properly documented and investigated, and that appropriate corrective actions are taken.

Choice A rationale:

Bounding peripheral pulses are not typically associated with diabetes insipidus. Diabetes insipidus is a condition characterized by excessive thirst and excretion of large amounts of severely dilute urine.

Choice B rationale:

Moist mucous membranes are not a common finding in diabetes insipidus. In fact, due to excessive urination, patients may experience dehydration which can lead to dry mucous membranes.

Choice C rationale:

Bradycardia, or a slower than normal heart rate, is not a typical symptom of diabetes insipidus. The condition does not directly affect the heart rate.

Choice D rationale:

Decreased urine specific gravity is a key finding in diabetes insipidus. The condition causes an imbalance of water in the body, leading to the production of large amounts of dilute (or low specific gravity) urine.

Please note that these rationales are based on general knowledge about diabetes insipidus and the specific symptoms mentioned in the choices. For a more detailed understanding, it’s recommended to refer to medical textbooks or consult with healthcare professionals.