A nurse is teaching a class about providing care within the legal stope of practice to a group of nurses. The nurse should include that which of the following procedures is outside the legal scope of practice for an RN?

A. Occupational therapist: While occupational therapy may be beneficial for some aspects of managing sciatica, such as ergonomic assessments and activities of daily living modifications, a referral to an occupational therapist is not typically indicated specifically for the use of a TENS unit.
B. Chiropractor: Chiropractic care involves manual adjustments of the spine and other joints, which may provide relief for some individuals with sciatica. However, a referral to a chiropractor is not necessary solely for the use of a TENS unit.
C. Acupuncturist: Acupuncture is a complementary therapy that involves the insertion of thin needles into specific points on the body to relieve pain and promote healing. While acupuncture may be considered as part of a comprehensive treatment plan for sciatica, it is not typically associated with the use of a TENS unit.
D. Physical therapist: Physical therapy plays a crucial role in the management of sciatica. A physical therapist can provide tailored exercises, stretches, and modalities such as TENS therapy to alleviate pain, improve mobility, and strengthen muscles. Therefore, a referral to a physical therapist is appropriate for a client with sciatica who has a prescription for a TENS unit. The physical therapist can assess the client's condition, educate them on the proper use of the TENS unit, and integrate it into their overall treatment plan.

A. Acute hemolytic:
Acute hemolytic transfusion reactions typically present with symptoms such as fever, chills, flank pain, hemoglobinuria (blood in the urine), and possibly hypotension. This occurs due to the rapid destruction of transfused red blood cells, often because of ABO incompatibility between the donor and recipient. The symptoms described in the scenario, including chest tightness, are not consistent with acute hemolytic reactions.

B. Allergic:
Allergic reactions to blood transfusions can manifest with symptoms such as itching, hives, flushing, and mild respiratory distress. While headache and low-back pain can occur in allergic reactions, the feeling of "tightness" in the chest is more indicative of another type of reaction.

C. Bacterial:
Bacterial contamination of blood products can lead to transfusion-related sepsis. Symptoms may include fever, chills, hypotension, and rapid onset of shock. However, the presence of headache and low-back pain, along with chest tightness, is not typically associated with bacterial contamination.

D. Febrile nonhemolytic:
Febrile nonhemolytic transfusion reactions are characterized by fever, chills, and rigors. While fever and chills are common symptoms, they do not typically cause chest tightness or low-back pain.