A nurse leader is preparing an educational program on infection control measures. Which of the following conditions should the nurse include when discussing contact precautions?

Choice A reason: Applying a saturated abdominal dressing (with sterile normal saline) is correct. Moist dressings prevent the exposed abdominal organs from drying out and reduce the risk of tissue necrosis. This is the immediate priority intervention until surgical repair can be performed.

Choice B reason: Cleansing the site with hydrogen peroxide is inappropriate because it can damage exposed tissues and increase the risk of infection. Hydrogen peroxide is not used for internal organ exposure.

Choice C reason: Covering the site with dry, sterile gauze is incorrect because dry gauze can adhere to the viscera, causing tissue damage when removed. Moist dressings are required to protect the organs.

Choice D reason: Reinserting protruding viscera is unsafe and contraindicated. Attempting to push organs back into the abdominal cavity can cause trauma, infection, and further complications. The nurse should protect the viscera and notify the surgical team immediately.

Choice A reason: Inserting a nasogastric tube requires specialized knowledge and skill. It involves assessing the client’s gag reflex, airway protection, and verifying placement, often with radiographic confirmation. This procedure carries risks such as aspiration, airway trauma, or incorrect placement into the lungs. Because of these risks, it is considered a nursing responsibility and cannot be delegated to assistive personnel.

Choice B reason: Converting a continuous IV infusion catheter to an intermittent infusion lock requires sterile technique and knowledge of vascular access. It involves flushing the catheter, maintaining patency, and preventing infection. These tasks require clinical judgment and are outside the scope of practice for assistive personnel.

Choice C reason: Changing an appliance for a client who has an established ostomy is appropriate to delegate. Once the ostomy is established and stable, the task becomes routine and does not require complex assessment. Assistive personnel can safely perform this under the nurse’s supervision, as it involves hygiene, comfort, and routine care rather than advanced clinical judgment.

Choice D reason: Evaluating the care of a client receiving speech therapy requires assessment skills and professional judgment. Evaluation involves determining progress, identifying barriers, and coordinating with the interdisciplinary team. This is a nursing responsibility and cannot be delegated to assistive personnel.