A nurse is receiving report on a group of clients. Using the ABCDE priority framework which f the following clients should the nurse see first?

A) Use hot water so rinse hand sanitizer off:
Using hot water is not recommended when performing hand hygiene with alcohol-based hand sanitizer. Alcohol-based sanitizers do not require rinsing off, as they are designed to evaporate quickly, killing germs as they dry. Rinsing with water, especially hot water, can dilute the sanitizer, reducing its effectiveness. Hands should be left to dry naturally after applying the sanitizer.

B) Dry hands with a reusable towel:
While towels can be used for drying hands after washing with soap and water, they should not be used after alcohol-based hand sanitizers. Alcohol hand sanitizers should be allowed to air dry on the hands. Using a towel could reintroduce contaminants and diminish the effectiveness of the sanitizer. Ideally, hands should be rubbed together until they are dry without the need for any towel.

C) Rub hands together for 20 seconds:
Alcohol-based hand sanitizers are effective in killing germs in a short amount of time—usually within 20 seconds or less. However, the correct technique for using alcohol-based hand sanitizers involves rubbing hands together until they are completely dry, not for a full 20 seconds as one might with handwashing. The important factor is ensuring the sanitizer has covered all surfaces of the hands, including between fingers and around nails, before allowing it to air dry.

D) Rub hand sanitizer around rings on fingers:
Rubbing the hand sanitizer around rings is a necessary step. Jewelry, such as rings, can harbor bacteria or other pathogens, making it essential to ensure the sanitizer comes into contact with areas that are often missed during hand hygiene, like around rings. The nurse should rub the hand sanitizer thoroughly over all surfaces of the hands, including around jewelry, to ensure effective hand hygiene.

A) Teach the use of an incentive spirometer to a postoperative client:
Teaching a patient how to use an incentive spirometer involves assessment, education, and clinical judgment. This task requires the nurse's expertise to ensure that the patient understands how to use the device correctly and to assess for any potential complications, such as inadequate lung expansion.

B) Irrigate and perform a dressing change for a client who has a pressure injury wound:
Irrigating and changing the dressing of a pressure injury involves clinical judgment, the need for sterile technique, and the assessment of the wound. These tasks should be performed by a registered nurse (RN), who can assess the condition of the wound, evaluate for signs of infection, and make decisions regarding further care.

C) Administer oral PRN pain medication to a client who has arthritis:
Administering PRN pain medication requires assessment of the patient's pain level, consideration of the medication’s effects, and clinical judgment regarding the appropriateness of the medication. This is a nursing responsibility because it involves both medication management and the evaluation of therapeutic effects.

D) Obtain a daily weight on a client who has heart failure:
Obtaining a daily weight is a task that can be safely delegated to an assistive personnel (AP). Weight is an important measurement for monitoring fluid status, especially in clients with heart failure. The AP can accurately weigh the client, ensuring that the same scale and conditions (such as time of day, after the patient has voided) are followed each time.