A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching?

A. Requiring staff nurses to demonstrate competency by passing a medication administration examination: While competency assessments are essential, initiating this as the first strategy may not address the root causes of medication administration errors. It's important to first understand the specific factors contributing to errors by reviewing the events leading up to each error before implementing competency assessments. This allows for a targeted approach to addressing gaps in knowledge or skills related to medication administration.
B. Providing an in-service on medication administration to all nurses: While education and training are valuable components of error reduction strategies, providing an in-service as the first step may not address the underlying system issues contributing to medication errors. Education should complement other interventions aimed at improving the medication administration process, such as system redesign or standardization of practices.
C. Developing a quality improvement program for nurses involved in medication administration errors: Implementing a quality improvement program for nurses involved in errors is important for learning from mistakes and preventing recurrence. However, developing such a program should be informed by a thorough analysis of the events leading to errors. Without understanding the root causes, it may be challenging to develop effective improvement initiatives.
D. Reviewing the events leading up to each medication administration error: This strategy is the most appropriate initial step. Conducting a detailed review of each error allows the committee to identify patterns, common factors, and system issues contributing to medication errors. By understanding the specific circumstances surrounding each error, the committee can develop targeted interventions to address root causes and prevent future errors. This approach aligns with the principles of continuous quality improvement, focusing on data-driven analysis and proactive problem-solving.

A. Dry the skin: The priority nursing action immediately following birth is to ensure the newborn's warmth. Drying the newborn's skin helps prevent hypothermia, which is a significant risk for neonates. The nurse should dry the newborn's skin using a warm, dry towel to prevent heat loss through evaporation.
B. Administer vitamin K: Administering vitamin K is an important procedure shortly after birth to prevent hemorrhagic disease of the newborn. However, ensuring warmth by drying the skin takes precedence over administering vitamin K as the newborn's temperature regulation is crucial immediately after delivery.
C. Place an identification bracelet: Placing an identification bracelet on the newborn is essential for proper identification and security purposes, but it is not the priority immediately after birth. Ensuring the newborn's warmth and maintaining physiological stability take precedence.
D. Administer eye prophylaxis: Administering eye prophylaxis, typically in the form of erythromycin ointment or another antimicrobial agent, is important to prevent neonatal conjunctivitis due to exposure to maternal pathogens during delivery. However, this intervention can wait until after the newborn's warmth is ensured through drying the skin.