An unlicensed assistive personnel (UAP) is assisting with the care of a client with a peripherally inserted central venous catheter (PICC). Which guidance should the practical nurse (PN) provide to the UAP?
Be sure to keep the head of the client's bed elevated.
Change the dressing over the catheter insertion site.
Feed the client all meals to reduce arm movement.
Use the opposite arm for blood pressure measurement.
The Correct Answer is D
A. Keeping the head of the bed elevated is not specifically related to the care of a PICC line. The elevation may be a general comfort measure but is not a specific instruction for PICC line management.
B. Changing the dressing over the PICC line insertion site is a sterile procedure that should be performed by a licensed nurse, not a UAP. This task requires specific training and adherence to infection control practices.
C. Feeding the client all meals to reduce arm movement is not necessary and may be overly restrictive. The UAP’s role does not include limiting the client's activity beyond reasonable measures.
D. Using the opposite arm for blood pressure measurement is the correct guidance. It prevents potential interference with the PICC line and helps avoid complications such as dislodgement or infection.
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Related Questions
Correct Answer is D
Explanation
A. Assigning the UAP to more stable clients does not address the immediate issue of the protocol omission and does not ensure that the protocol is followed correctly in the future.
B. Completing an unusual occurrence report is not necessary if the omission was corrected and the situation does not involve a significant error or safety issue.
C. Reporting to the charge nurse may be appropriate, but the priority is to ensure the UAP understands and follows the protocol, which is best achieved through direct supervision.
D. Supervising the UAP and reviewing the protocol ensures that the UAP understands and adheres to the fall prevention protocol moving forward, addressing both the immediate issue and future adherence.
Correct Answer is D
Explanation
A. Bringing the client to sit at the nursing station may not address the underlying cause of the wandering behavior and could be less effective in meeting the client’s immediate needs.
B. Administering a nighttime sedative is not a suitable solution for wandering behavior, as it may lead to adverse effects and does not address the root cause of the behavior.
C. Directing the client to go back to bed may not be effective, especially if the client is disoriented or confused. The approach should involve understanding and addressing the client's needs.
D. Engaging the client to determine current needs is the best approach, as it helps to understand the cause of the wandering and address it appropriately, such as providing comfort, reassurance, or addressing a specific need.
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