A nurse is planning care for clients.
Which of the following tasks can the nurse delegate to an assistive personnel (AP)?

Choice A rationale:

Guiding the client away from background noise is a helpful suggestion for a client with hearing loss, but in the context of reviewing discharge instructions, it may not be sufficient. The primary issue is not background noise but the ability of the client to hear and understand the nurse's instructions.

Choice B rationale:

Providing a copy of the instructions printed in Braille is not appropriate for a client with hearing loss. Braille is a tactile reading and writing system for people who are blind or visually impaired. It does not address the client's hearing loss.

Choice C rationale:

Standing next to the client when speaking is the most appropriate action for a nurse when reviewing discharge instructions with a client who has hearing loss. This allows the client to see the nurse's facial expressions, lip movements, and gestures, which can aid in understanding. It also minimizes the distance between the nurse's mouth and the client's ears, making it easier for the client to hear.

Choice D rationale:

While repeating phrases that the client misunderstands is a helpful communication strategy, it should be used in conjunction with standing close to the client, not as the sole method. Standing close and speaking clearly should be the primary approach to facilitate effective communication with a client who has hearing loss.

The correct answer is B.

Choice A reason: Using a stiff toothbrush to clean the client’s teeth is not recommended. A stiff toothbrush can cause damage to the gums and teeth, especially in clients who may have sensitive oral tissues due to medications or medical treatments.

Choice B reason: Turning the client on his side before starting oral care is the most appropriate action. This is to prevent aspiration, especially in immobile clients who may have difficulty swallowing or clearing their throat.

Choice C reason: Using the thumb and index finger to keep the client’s mouth open is not recommended. This could be uncomfortable or even harmful for the client. Instead, a padded tongue blade could be used if necessary, but only with extreme caution and the client’s comfort in mind.

Choice D reason: Applying petroleum jelly to the client’s lips after oral care is also a good practice. This helps to prevent dryness and cracking of the lips, which can be a common problem for hospitalized patients, especially those who are dehydrated or receiving oxygen therapy. However, when compared to choice B, it is not as critical in terms of immediate safety concerns.