A nurse is giving a report to their supervisor. Which of the following indicates a need for client care to be transferred to a registered nurse?

A. Make a schedule of daily tasks: Establishing a consistent daily routine helps reduce confusion and frustration in clients with Alzheimer's disease. Predictable schedules provide structure, promote independence, and create a sense of security.

B. Have several family members visit daily: While social interaction is important, having too many visitors at once or a constant rotation of people can lead to overstimulation. For a client with Alzheimer's, high-stimulus environments often trigger agitation, confusion, or "sundowning.

C. Limit the use of familiar objects: Surrounding the client with meaningful items—such as family photos, a favorite chair, or personal mementos—helps with reorientation and provides emotional comfort. Removing these objects can increase the client's sense of isolation and disorientation, leading to greater frustration.

D. Ask questions that require more than one answer: Complex questions may be difficult for the client to answer, potentially causing frustration. Simple, clear questions are more appropriate to promote communication and reduce stress.

A. The client needs routine wound care performed: Routine wound care is a stable, predictable task that can be delegated to assistive personnel. It does not require the judgment or assessment skills of a registered nurse.

B. The client develops a postoperative fever: A postoperative fever may indicate infection or another complication that requires assessment, clinical judgment, and possible intervention by a registered nurse. This warrants transfer of care to the RN for evaluation and appropriate action.

C. The client is experiencing a therapeutic effect from their treatment: Observing a therapeutic response is expected and does not necessitate RN-only care. Monitoring for ongoing effectiveness can be performed by other trained personnel as appropriate.

D. The client needs strict measurement of intake and output: While accurate intake and output monitoring is important, it is a routine, measurable task that can be delegated to assistive personnel. It does not require RN assessment unless abnormalities are noted.