A nurse is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome. Which of the following recommendations should the nurse include?

A. The client is voiding at least 250 mL/hr: Normal urine output for adults is approximately 30 mL/hr. Voiding 250 mL/hr is unusually high and may indicate overhydration or diuresis; this is not an expected postoperative finding.

B. The client is maintaining bed rest: Early ambulation is encouraged after gastric banding to prevent complications such as venous thromboembolism, pneumonia, and delayed bowel function. Prolonged bed rest is not an expected or recommended postoperative behavior.

C. The client is tolerating clear liquids: After gastric banding, clients are typically advanced to clear liquids initially, progressing slowly to full liquids and soft foods as tolerated. Tolerance of clear liquids at 36 hours postoperatively is an expected and appropriate finding.

D. The client is consuming 1,000 calories daily: Postoperative dietary intake is extremely limited immediately following gastric banding. Consuming 1,000 calories per day this early is not typical, as intake usually starts with small, frequent, clear-liquid servings.

A. State Nurse Practice Act: The State Nurse Practice Act defines the legal scope of practice for nurses within that state, including permissible tasks, delegation guidelines, and licensure requirements. Consulting it ensures that the nurse acts within legal and professional boundaries.

B. Verbal direction from the nurse manager: While guidance from a manager can clarify expectations, it does not supersede legal regulations or define the nurse’s authorized scope of practice. Following only verbal instructions without legal backing may place the nurse at risk of practicing outside their scope.

C. Institutional policies and procedures: Policies provide guidance on how tasks should be performed safely within a facility, but they do not define the nurse’s legal scope of practice. These should be used in conjunction with state regulations, not as the primary authority.

D. Written prescription from the provider: A provider’s order indicates what care is needed for the client but does not grant a nurse legal authority to perform tasks outside their scope of practice. The nurse must ensure the action is permitted under state law before implementation.