A nurse is preparing to discharge a client who is a status post-operative laryngectomy. The nurse should recognize which of the following discharge teaching is the highest priority?

A. Supportive feedback: This term refers to positive, constructive input that aims to help a colleague improve their practice or decision-making. Nurse Taylor's behavior does not reflect supportive feedback; rather, it is negative and undermining, contributing to a hostile work environment.
B. Lateral violence: This term describes aggressive or bullying behavior exhibited by colleagues at the same hierarchical level. Nurse Taylor's sarcastic remarks and belittling comments toward Nurse Jordan are clear examples of lateral violence, as they create a toxic atmosphere and negatively impact team dynamics. This behavior can lead to increased stress and decreased morale among team members.
C. Workplace violence: While Nurse Taylor's behavior can be considered a form of workplace violence in a broader sense, it is more specifically classified as lateral violence. Workplace violence generally encompasses physical threats or harm, while lateral violence focuses on verbal and emotional abuse among coworkers.
D. Constructive criticism: Constructive criticism involves providing feedback aimed at improving performance while maintaining respect and professionalism. Nurse Taylor's sarcastic remarks do not meet this definition, as they are not aimed at helping Nurse Jordan but rather serve to belittle and undermine her. Therefore, this behavior is not constructive and instead falls into the category of lateral violence.

A. Auscultate lungs for the presence of breath sounds: This is the priority action following endotracheal intubation, as it directly assesses the effectiveness of the intubation. Auscultating the lungs allows the nurse to confirm that the endotracheal tube is properly positioned in the trachea and that air is reaching the lungs. Abnormal breath sounds, such as decreased or absent sounds on one side, may indicate improper placement or complications like a pneumothorax, making this assessment critical for patient safety.
B. Assess baseline level of consciousness: While assessing the client's level of consciousness is important for evaluating their overall neurological status, it is not the immediate priority following intubation. Changes in consciousness can be influenced by various factors, including sedation or hypoxia, but ensuring proper airway placement and ventilation is more urgent to prevent respiratory compromise.
C. Assess for the presence of circumoral cyanosis: Circumoral cyanosis can indicate inadequate oxygenation, but it may not be immediately apparent after intubation. This assessment is important, but it is secondary to confirming that breath sounds are present and that the airway is secure. Identifying airway placement issues is more crucial before evaluating for signs of hypoxia.
D. Determine that the pulse oximetry is greater than 95%: Monitoring pulse oximetry is essential for assessing oxygen saturation and identifying potential hypoxia. However, if the endotracheal tube is not properly placed, the pulse oximetry may not accurately reflect the client’s respiratory status. Therefore, ensuring proper ventilation through auscultation of breath sounds takes precedence over solely relying on pulse oximetry readings.