A nurse is teaching a newly licensed nurse about advance directives. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Choice A reason: Meningococcal immunizations are recommended for sickle cell anemia to prevent infections due to functional asplenia, not avoided. Reporting headaches is critical. Advising avoidance risks increased infection susceptibility, potentially causing life-threatening sepsis, critical to prevent in children with sickle cell anemia managing care at home.

Choice B reason: Restricting fluid intake is contraindicated in sickle cell anemia; hydration prevents vaso-occlusive crises. Reporting headaches is priority. Advising restriction risks dehydration, triggering crises, pain, or organ damage, critical to avoid in ensuring safe home management and preventing complications in children with sickle cell disease.

Choice C reason: Reporting sudden, persistent headaches is critical in sickle cell anemia, as they may indicate stroke or cerebral vaso-occlusion, requiring urgent evaluation. This instruction ensures early intervention, preventing neurological damage, essential for safe home management, and improving outcomes in children with sickle cell disease at risk for complications.

Choice D reason: Cold compresses may worsen vaso-occlusive pain in sickle cell anemia by constricting vessels; warm compresses are preferred. Reporting headaches is more critical. Advising cold risks exacerbating pain, delaying effective management, critical to avoid in ensuring comfort and preventing crises in home care for sickle cell anemia.

Choice A reason: Obtaining vital signs every 4 hours is within the assistive personnel’s scope, ensuring timely monitoring without requiring nursing judgment. Delegating this frees nurses for complex tasks, enhancing efficiency. Proper training ensures accuracy, critical for detecting changes in client status, supporting safe care delivery in busy clinical settings.

Choice B reason: Inserting an NG tube requires nursing skills for assessment and placement verification, not suitable for assistive personnel. Delegating this risks complications like misplacement, potentially causing aspiration or injury, critical to avoid. Nurses must perform this, ensuring safety and accuracy in clients needing enteral feedings.

Choice C reason: Recording intake after meals is an appropriate task for assistive personnel, involving observation and documentation, not clinical judgment. Delegating this supports nutritional monitoring, freeing nurses for higher-level tasks. Training ensures accurate records, critical for assessing fluid and nutritional status in clients across various clinical conditions.

Choice D reason: Transferring a client to physical therapy is within assistive personnel’s scope, involving safe mobility assistance, not clinical decision-making. Delegating this enhances workflow, allowing nurses to focus on complex care. Proper training ensures safety, critical for preventing falls and supporting rehabilitation in clients requiring physical therapy.

Choice E reason: Instructing on incentive spirometer use requires nursing expertise to teach technique and assess understanding, not suitable for assistive personnel. Delegating risks ineffective use, potentially leading to atelectasis. Nurses must provide this education, ensuring proper respiratory care, critical for preventing complications in clients at risk for lung issues.