A nurse is teaching a class about the interlocking principles of shared governance. Which of the following principles should the nurse include?

(Select All that Apply.)

A. Teaching a client how to use an incentive spirometer involves providing detailed instruction and education about the device and its use. This task requires clinical knowledge and the ability to assess and address the client’s understanding, which is beyond the scope of an AP.
B. Irrigating and performing a dressing change on a pressure injury wound is a clinical task that requires specific training and skill, including knowledge of wound care, infection control, and assessment of wound healing. This is typically performed by an RN or another licensed healthcare professional. This task involves clinical judgment and assessment, which are beyond the training of an AP.
C. Administering medication, including PRN (as needed) pain medication, involves assessing the client’s condition, verifying the medication order, and monitoring for effects and side effects. This task requires a licensed nurse who can perform these assessments and make clinical decisions.
D. Obtaining a daily weight is a task that is within the scope of practice for an AP. Weighing a client does not require clinical judgment or complex decision-making and is typically considered a routine task that can be safely delegated to an AP. This task involves measuring and recording the client’s weight, which is an objective and straightforward task.

A. While acting as a mediator between the client and the provider is an important aspect of advocacy and communication, it is not directly related to accountability. Mediation involves facilitating communication and resolving conflicts, which are important for effective care but do not specifically address taking responsibility for one's own actions and decisions.
B. This is an example of accountability. Following the rights of medication administration—such as checking the right patient, medication, dose, route, and time—is a critical responsibility of the nurse. Ensuring that these rights are adhered to demonstrates accountability in medication management, as the nurse is taking responsibility for administering medications safely and correctly.
C. Supporting a client’s right to refuse medication is an important aspect of patient autonomy and ethical practice. While it reflects respect for the client’s choices and rights, it is more related to advocacy and ethical principles rather than directly demonstrating accountability for one’s own actions.

D. Ensuring that a client understands the adverse effects of their medication involves educating the client and ensuring informed consent. This is an important aspect of patient education and care but is not solely an example of accountability. Accountability would involve taking responsibility for making sure that this education is provided correctly and thoroughly.