A nurse is planning care for a client who is at 36 weeks of gestation and has preeclampsia with severe features. Which of the following actions should the nurse plan to implement?

Rationale:

A. Assign the AP to ask the client if she has taken her antidiabetic medication today: Asking about medication adherence is part of assessment and requires clinical judgment. Delegating this task to an AP is inappropriate because it involves interpreting client responses and making clinical decisions.

B. Determine if the AP has the skills to perform the test: Before delegating any task, the nurse must verify that the AP is competent and trained to perform the procedure safely. Ensuring skill competency protects the client from harm and aligns with the nurse’s responsibility for delegation.

C. Have the AP check the medical record for prior blood glucose test results: Reviewing medical records and interpreting trends involves clinical judgment and falls outside the typical scope of practice for an AP. This task should remain with the licensed nurse.

D. Help the AP perform the blood glucose test: Assisting the AP is not necessary if the AP is competent and has been properly trained. The nurse’s role is to delegate appropriately, supervise as needed, and ensure safe completion, rather than performing the task alongside the AP.

Rationale:

A. Forearm: The forearm is not a recommended site for subcutaneous injections because it has limited subcutaneous tissue and is typically reserved for intradermal injections, such as allergy testing or tuberculosis screening.

B. Ventrogluteal: The ventrogluteal site is preferred for intramuscular injections due to the large muscle mass and low risk of nerve injury. It is not suitable for subcutaneous injections, which require fatty tissue rather than muscle.

C. Outer posterior aspect of upper arm: This site contains adequate subcutaneous tissue, is easily accessible, and is commonly used for subcutaneous injections such as insulin or heparin. It allows for proper absorption and minimizes the risk of intramuscular administration.

D. Vastus lateralis: The vastus lateralis is part of the thigh and is primarily used for intramuscular injections, especially in infants or adults needing large-volume IM medications. It is not a typical site for subcutaneous injections.