A nurse is serving on a committee whose task is to plan cost-effective care at the facility. Which of the following client care tasks should the nurse recommend?

Choice A Reason:
White blood cell count (WBC) is incorrect. Melena, which is the passage of black, tarry stools, is typically associated with upper gastrointestinal bleeding rather than an infection. While changes in WBC count might occur in response to infection or inflammation, it is not the primary laboratory test to monitor in response to melena.
Choice B Reason:
Glucose is incorrect.
Glucose monitoring is important for assessing blood sugar levels, particularly in diabetic patients or those at risk of hypoglycemia or hyperglycemia. However, it is not directly related to the presence of melena, which indicates gastrointestinal bleeding.
Choice C Reason:
Blood urea nitrogen (BUN) is incorrect. Blood urea nitrogen (BUN) levels can indicate renal function and hydration status, but they are not specifically related to the presence of melena. Monitoring BUN may be relevant in other clinical contexts, such as assessing kidney function or dehydration, but it's not the primary laboratory test to monitor in response to melena.
Choice D Reason:
Hematocrit is correct. Melena indicates upper gastrointestinal bleeding, which can lead to a significant loss of blood. Monitoring the hematocrit level is crucial in this context because it helps assess the severity of bleeding and guide appropriate interventions such as blood transfusions if necessary. A decrease in hematocrit indicates a decrease in the volume of red blood cells, which reflects blood loss and the need for further evaluation and management.

Choice A Reason:
Replacing total parenteral nutrition solution bags every 48 hr is incorrect. Total parenteral nutrition (TPN) solution bags typically need to be replaced more frequently than every 48 hours to prevent bacterial contamination and ensure the integrity of the solution. However, the frequency of bag changes may vary depending on institutional protocols and specific patient needs.
Choice B Reason:
Replacing peripheral IV solution bags every 96 hr is incorrect. Peripheral IV solution bags may be changed less frequently than every 96 hours, as long as the solution remains sterile and the integrity of the infusion system is maintained. However, the frequency of bag changes may vary based on institutional policies and patient-specific factors.
Choice C Reason:
Changing peripheral IV primary tubing every 96 hr is correct. Changing peripheral IV primary tubing every 96 hours is a recommendation consistent with infection control guidelines and helps prevent contamination and bloodstream infections. This practice is cost-effective while ensuring patient safety.
Choice D Reason:
Changing total parenteral nutrition IV tubing every 48 hr is incorrect. Total parenteral nutrition (TPN) IV tubing typically needs to be changed more frequently than every 48 hours to prevent bacterial contamination and ensure the integrity of the TPN solution. However, the frequency of tubing changes may vary depending on institutional protocols and patient-specific factors.