It is most important for the registered nurse (RN) who is working on a medical unit to provide direct supervision in which situation?
A practical nurse is preparing to assist the healthcare provider with a lumbar puncture at the bedside.
A postpartum nurse pulled to the unit needs to start a transfusion of packed red blood cells.
An unlicensed assistive personnel is preparing to weigh an obese bedfast client using a bed scale.
A graduate nurse needs to access a client's implanted port to start an infusion of Ringer's Lactate.
The Correct Answer is A
Choice A: A practical nurse assisting the healthcare provider with a lumbar puncture at the bedside is a high-risk procedure that requires direct supervision by an RN or a qualified healthcare provider. The RN should ensure the procedure is performed safely and effectively, as it involves potential risks and complications.
Choice B: Starting a transfusion of packed red blood cells is an important nursing intervention, but it does not necessarily require direct supervision by an RN, especially if the nurse has been trained and is competent in administering blood transfusions.
Choice C: Weighing an obese bedfast client using a bed scale is a routine nursing task that can be performed by unlicensed assistive personnel (UAP) with appropriate training. While the RN should ensure that the UAP is properly trained, direct supervision may not be required for this specific task.
Choice D: Accessing a client's implanted port to start an infusion of Ringer's Lactate is a nursing task that can be performed by a graduate nurse, especially if they have received appropriate training and competency validation. Direct supervision by an RN may not be necessary in this situation.
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Related Questions
Correct Answer is D
Explanation
A. Serum protein is an indicator of the client’s overall nutritional status, but it is not as immediately critical to monitor as glucose levels in clients receiving TPN. Protein levels change more slowly over time and are not an acute concern.
B. While serum osmolarity is important in evaluating hydration status and electrolyte balance, it is not the primary lab to monitor during TPN administration. Glucose fluctuations are more likely to cause immediate complications.
C. Urinary ketones are typically monitored in clients with diabetic ketoacidosis (DKA), not in clients receiving TPN. Ketones are a byproduct of fat metabolism and are not a priority in TPN management.
D. Capillary glucose is the most important lab to monitor in clients on TPN because TPN solutions contain high amounts of glucose, which can lead to hyperglycemia. Monitoring glucose levels helps prevent complications such as hyperglycemia or hypoglycemia and is critical in managing the client's metabolic response to TPN.
Correct Answer is ["A","B","F"]
Explanation
Choice A: Confirming information from the solution label is essential to ensure that the correct parenteral nutrition solution is being administered.
Choice B: Confirming the healthcare provider's prescription is critical to verify the type, rate, and duration of the parenteral nutrition therapy, as well as any specific additives or electrolyte requirements.
Choice C: The medication administration record (MAR) is not directly related to parenteral nutrition, so it is not a primary source of information for this specific procedure.
Choice D: Measured residual volume is relevant for enteral nutrition administration but is not applicable to parenteral nutrition.
Choice E: The dietitian's progress notes may provide valuable information about the client's overall nutrition plan but are not the primary source for confirming the immediate administration of a specific parenteral nutrition solution.
Choice F: Confirming the client's identification band is essential to ensure the correct client receives the parenteral nutrition and to prevent errors in administration.
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