A nurse is planning to conduct a support group for adolescents who have cancer.
Which of the following actions should the nurse include during the orientation phase?

Choice A rationale:

After a total gastrectomy, the client lacks the intrinsic factor necessary for the absorption of vitamin B12 in the terminal ileum. Therefore, vitamin B12 supplementation is essential to prevent pernicious anemia, a condition caused by vitamin B12 deficiency. The absence of intrinsic factor hinders the absorption of vitamin B12 from dietary sources, making it necessary to provide this vitamin through injections or high-dose oral supplements. Vitamin B12 supplementation is a standard practice following a total gastrectomy.

Choice B rationale:

Ranitidine is a histamine-2 (H2) receptor antagonist used to reduce stomach acid production. It is not directly related to vitamin B12 deficiency and is not typically prescribed following a total gastrectomy. Vitamin B12 supplementation, on the other hand, addresses the specific deficiency caused by the absence of intrinsic factor.

Choice C rationale:

Vitamin K is essential for blood clotting and bone health. However, it is not the primary concern following a total gastrectomy. Vitamin B12 deficiency leading to pernicious anemia is the major focus of post-gastrectomy supplementation. While vitamin K may be important for overall health, it is not the immediate priority in this scenario.

Choice D rationale:

Metoclopramide is a medication used to treat gastrointestinal disorders, including gastroparesis and gastroesophageal reflux disease (GERD). It does not directly address the vitamin B12 deficiency resulting from the absence of intrinsic factor. Vitamin B12 supplementation is specifically indicated to prevent pernicious anemia in this context.

The correct answer is: b. Determine goals of the day.

Choice A: Schedule daily activities.

Rationale: Scheduling daily activities is crucial for time management but should follow establishing goals. The nurse must first determine the priorities and objectives for the day before organizing the tasks.

Choice B: Determine goals of the day.

Rationale: Identifying the goals of the day is the first step in effective time management for a nurse. This enables the nurse to prioritize patient care and other responsibilities, ensuring that essential tasks are accomplished and patient needs are met. Goals can include completing assessments, administering medications, and attending to patient concerns.

Choice C: Delegate tasks to the AP.

Rationale: Delegating tasks is vital in managing time and resources, but it should occur after the goals and priorities are determined. The nurse must first know which tasks need to be completed before assigning responsibilities to the LPN and AP.

Choice D: Develop an hourly time frame for tasks.

Rationale: Creating a timeline for tasks is essential for time management but should be done after setting goals and prioritizing tasks. This will enable the nurse to allocate an appropriate amount of time for each task and help ensure that all necessary tasks are completed within the shift.

In conclusion, by first determining the goals of the day, the nurse can effectively manage time and ensure that all essential tasks are completed. Prioritizing patient care and other responsibilities will enable the nurse to collaborate effectively with the LPN and AP in delegating tasks and scheduling activities.