A nurse is teaching about safe handling of formula to a client who is postpartum and chooses to bottle feed her newborn.
Which of the following statements by the client indicates an understanding of the teaching?

"Have you had any stomach pain or bloody stools?"

Rationale:

• A. Muscle stiffness is not a common or serious adverse effect of ibuprofen. Ibuprofen is an antiinflammatory drug that can reduce pain and stiffness caused by arthritis.
• B. Stomach pain or bloody stools are signs of gastrointestinal bleeding, which is a serious and potentially fatal adverse effect of ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause ulceration, perforation, and hemorrhage of the stomach or intestines . The nurse should ask the client about any gastrointestinal symptoms and advise them to avoid alcohol, smoking, and other NSAIDs while taking ibuprofen.
• C. Dry cough is not a common or serious adverse effect of ibuprofen. Dry cough is more likely to be caused by angiotensin-converting enzyme (ACE) inhibitors, which are used to treat hypertension and heart failure.
• D. Increase in urine output is not a common or serious adverse effect of ibuprofen. Ibuprofen can cause renal impairment, which can lead to decreased urine output, not increased urine output. The nurse should monitor the client's renal function tests and fluid balance while taking ibuprofen.

The correct answer is Choice A.

Choice A rationale:

Forming a committee of staff members to investigate current staffing issues is the first step the nurse manager should take. This is because it is important to understand the root cause of the problem before implementing any changes. The committee can gather data, identify patterns, and provide insights into why staffing for weekend shifts is a challenge. This could involve surveying staff members, reviewing shift patterns, and analyzing workload and patient acuity data. By involving staff members in the process, the nurse manager can ensure that the perspectives and experiences of those directly affected by the staffing issues are taken into account. This approach aligns with the principles of shared governance and participatory management, which have been shown to improve staff satisfaction and retention.

Choice B rationale:

While providing support to staff members who are resistant to staffing changes is an important part of change management, it is not the first step that should be taken. Resistance to change is often a symptom of deeper issues, such as lack of trust, poor communication, or perceived lack of fairness or respect. By first forming a committee to investigate the staffing issues (Choice A), the nurse manager can gain a better understanding of these underlying issues and address them directly. This can help to reduce resistance when changes are implemented.

Choice C rationale:

Scheduling a staff meeting to present different options to staff members is a key part of the change process, but it should not be the first step. Before presenting options, it is important to fully understand the problem and consider various possible solutions. This involves investigating the current staffing issues (Choice A) and potentially developing and evaluating different scheduling options. Once this has been done, the options can be presented to staff members for feedback and discussion.

Choice D rationale:

Giving staff members advance written notice of staffing changes is a crucial part of transparent and respectful communication. However, it is not the first step in addressing staffing issues. Before any changes can be announced, the nurse manager needs to understand the problem (Choice A), consider possible solutions, and involve staff members in the decision-making process (Choice C). Once a decision has been made, it should be communicated clearly and promptly to all staff members.