A nurse working in a long-term care facility is assigned to care for four clients following the 0700 morning change-of-shift report. Which of the following clients should the nurse attend to first?
A client who has bronchitis, began receiving antibiotics yesterday and has a temperature of 38.3°C (101°F).
A client who has COPD and has an oxygen saturation of 90%.
A client who has Alzheimer's and was restless during the night.
A client who has diabetes and had a 0600 blood glucose level of 60 mg/dL.
The Correct Answer is D
Of the four clients described, the nurse should attend to the client who has diabetes and had a 0600 blood glucose level of 60 mg/dL first. This client's blood glucose level is low and requires immediate intervention to prevent further complications.
Option A may require attention, but the client's condition is stable and they are receiving treatment.
Option B may also require attention, but an oxygen saturation of 90% is within an acceptable range for a client with COPD.
Option C may also require attention, but the client's restlessness during the night does not indicate an immediate need for intervention.
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Correct Answer is D
Explanation
The nurse should make the statement "I need to talk to you about unit expectations regarding timely completion of tasks" to resolve the conflict with the AP who has been taking long breaks and making personal phone calls. This statement is assertive and focuses on the issue at hand without blaming or attacking the AP. It also opens up a dialogue between the nurse and the AP to discuss the issue and find a resolution.
The other statements are not effective in resolving the conflict. Statements such as "Several staff members have commented that you don't do your fair share of the work" [a] and "You have been very inconsiderate of others by not completing your share of the work" [b] are accusatory and may make the AP defensive.
Threatening to inform the nurse manager [c] may also escalate the conflict and is not a constructive way to address the issue.
Correct Answer is D
Explanation
The nurse should ask the AP to perform the task of taking an ABG (arterial blood gas) specimen to the laboratory first. This is because ABG specimens need to be analyzed promptly to ensure accurate results. Timely analysis of ABG specimens is important for making clinical decisions and providing appropriate care to the client.
Option A is incorrect because giving fresh water to clients who do not have NPO status is not as time-sensitive as taking an ABG specimen to the laboratory.
Option B is incorrect because obtaining a routine urine sample from a client right after admission is not as time-sensitive as taking an ABG specimen to the laboratory.
Option C is incorrect because transporting a client to the radiology department for an x-ray is not as time-sensitive as taking an ABG specimen to the laboratory.
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