A nurse is transcribing the following provider prescriptions into a client's chart. Which of the following prescriptions should the nurse clarify?

Rationale

A. Respiratory therapist: Respiratory therapists focus on airway management, pulmonary function, and respiratory interventions. Assistance with dressing is not within their scope of practice and does not relate to pulmonary or ventilatory needs. Reporting dressing difficulties to them would not contribute to the client’s functional recovery.

B. Physical therapist: Physical therapists focus on mobility, strength, range of motion, and gait training. While they may help with lower extremity function, they do not specialize in teaching or assisting with self-care activities like dressing, which is a focus of occupational therapy.

C. Social worker: Social workers address psychosocial needs, discharge planning, and community resources. They are not directly involved in the client’s ability to perform activities of daily living such as dressing, so reporting this information to them would not address the immediate functional concern.

D. Occupational therapist: Occupational therapists specialize in activities of daily living, including dressing, grooming, and self-care. They can assess the client’s functional limitations, recommend adaptive equipment, and provide strategies to enhance independence in dressing following surgery. This ensures the client receives appropriate rehabilitation support.

Rationale for Correct Choices

• Oxygen saturation: The client’s oxygen saturation dropped from 95% to 90% on 1 L/min nasal cannula, indicating potential hypoxemia. Immediate assessment and intervention are required to prevent respiratory compromise.
• Behavioral findings: The client’s agitation and verbal report of “I feel like something is wrong” signal a possible early change in condition. Behavioral changes can precede vital sign abnormalities and should be promptly evaluated alongside physiological measures.

Rationale for Incorrect Choices

• Pain: While pain is reported at a moderate level, it is expected postoperatively and does not explain the sudden change in oxygen saturation or agitation. Pain should be addressed after assessing potential acute complications.
• WBC count: A slightly elevated WBC may reflect postoperative inflammation or infection but is not the immediate priority in the context of acute hypoxemia.
• Bowel findings: Hypoactive bowel sounds are typical after abdominal surgery due to anesthesia and are not an urgent concern compared with declining oxygenation and agitation.