A nurse is providing dietary teaching to the guardian of a preschooler who has celiac disease. Which of the following foods should the nurse recommend including in the preschooler's diet?

C. Obtain a client's vital signs every 4 hr:
This task can typically be delegated to assistive personnel (AP) who have been trained and deemed competent in measuring vital signs. Routine monitoring of vital signs, such as temperature, pulse, respirations, and blood pressure, is within the scope of practice for AP and does not require the specialized skills of a licensed nurse.

D. Record a client's intake after each meal:
Assistive personnel can be delegated the task of recording a client's intake after each meal. This involves documenting the amount and type of food and fluids consumed by the client. While assessment of intake may involve some judgment, AP can be trained to perform this task accurately and consistently.

E. Transfer a client to physical therapy:
Assistive personnel can assist with transferring clients to physical therapy sessions. This may include tasks such as assisting clients into a wheelchair or onto a stretcher and accompanying them to the therapy area. While ensuring client safety during transfers is crucial, AP can perform these tasks under the direction and supervision of licensed nursing staff or physical therapists.

A. Instruct a client on the use of an incentive spirometer:
Teaching clients how to use medical equipment, such as an incentive spirometer, typically requires specialized knowledge and skills that fall within the scope of practice of licensed nursing staff. Therefore, this task should not be delegated to assistive personnel.

B. Insert an NG tube for a client who requires enteral feedings:
Inserting an NG tube is a specialized nursing skill that requires training, expertise, and an understanding of anatomy, proper technique, and potential complications. This task should only be performed by licensed nursing staff, such as registered nurses (RNs) or licensed practical nurses (LPNs), who have received appropriate education and training.

Answer: B. Turn on the faucets in the client's sink.

Rationale:

A. Tell the client to gently stroke their lower abdomen:
Stroking the abdomen may promote some sensory stimulation, but it is not a well-supported or commonly used intervention to stimulate voiding reflexes in clients having difficulty urinating on bed rest.

B. Turn on the faucets in the client's sink:
The sound of running water is a non-invasive, evidence-based method known to trigger the urge to urinate by stimulating the micturition reflex. This auditory cue can help relax pelvic muscles and facilitate urination, especially in clients struggling to void while in bed.

C. Pour cool water over the client's perineum:
Pouring cool water may not effectively stimulate urination and may cause discomfort. If water is used to promote voiding, it should be warm, not cool, to relax the perineal muscles and increase the likelihood of voiding.

D. Instruct the client to lean slightly backward:
Leaning backward can misalign the urethra and bladder, making voiding more difficult, especially for a female client in a supine or semi-recumbent position. A forward-leaning posture, if possible, is more anatomically favorable to aid urination.