A nurse is reinforcing teaching with a client who is starting digoxin therapy to treat heart failure. The nurse should reinforce with the client that which of the following adverse effects is a possible indication of digoxin toxicity and should be reported to the provider?

Choice A Reason:

"I will put soiled dressings in a tied plastic bag before placing them in the trash." This statement indicates an understanding of proper infection prevention practices for someone who is HIV positive. Putting soiled dressings in a tied plastic bag before disposing of them in the trash helps contain potentially infectious materials and reduces the risk of accidental exposure to others.

Choice B Reason:

Using animal-skin condoms is not recommended for individuals with HIV. Latex or polyurethane condoms are recommended because they provide better protection against the transmission of HIV and other sexually transmitted infections.

Choice C Reason:

Placing used sharp items in an empty cereal box for disposal is not a safe method for handling sharps. Sharps should be disposed of in a puncture-resistant container specifically designed for sharps disposal.

Choice D Reason:

Using a mixture of one part peroxide to ten parts water for disinfecting hard surfaces may not be effective in killing all pathogens. It is better to use a commercially available disinfectant or follow specific guidelines for disinfection recommended by healthcare providers or public health agencies.

Choice A Reason:

The surgeon is incorrect. Surgeons primarily focus on the surgical procedure itself and the immediate postoperative care related to the surgery. They may not have a direct role in medication management or overall postoperative care beyond the surgical site.

Choice B Reason:

The pharmacist is incorrect. While pharmacists play a vital role in medication management, they typically focus on dispensing medications, providing drug information, and ensuring proper dosages and administration. They may not be directly involved in assessing fall rates or postoperative outcomes.

Choice C Reason:

The case manager is incorrect. Case managers are responsible for coordinating a patient's care and ensuring that it meets their overall healthcare needs. They may not have the expertise or authority to investigate and address specific safety concerns related to medication use and fall rates.

Choice D Reason:

The risk manager is correct. When a nurse identifies an issue related to patient safety, such as an increased fall rate associated with a specific medication like zolpidem, it is important to report these findings to the risk manager. The risk manager is responsible for assessing and addressing issues related to patient safety and quality improvement within the healthcare facility. They can investigate the matter further, collaborate with other members of the healthcare team, and implement necessary changes or protocols to mitigate the risk and improve patient safety. Reporting such findings to the risk manager is a crucial step in ensuring patient safety and quality of care.