The charge nurse in an emergency center is planning client care assignments for the staff. Which action may be safely delegated to the practical nurse (PN)?

Choice A Reason: This is the correct answer because the nurse should immediately inform the healthcare provider of the medication error and the client's condition. The healthcare provider may order antidotes, such as protamine sulfate for heparin and vitamin K for warfarin, to reverse the anticoagulant effects and prevent bleeding complications.

Choice B Reason: Monitoring for signs of bleeding is important but not the priority action for the nurse because it does not address the cause of the problem or prevent further harm. The nurse should monitor the client's vital signs, hemoglobin, hematocrit, and urine output, as well as check for any signs of bleeding, such as bruising, petechiae,

hematuria, hematemesis, melena, or epistaxis.

Choice C Reason: Completing an adverse occurrence report is important but not the priority action for the nurse because it does not provide immediate intervention or treatment for the client. The nurse should complete an

adverse occurrence report after notifying the healthcare provider and implementing appropriate actions. The report should include the details of the error, such as the time, dose, route, and name of the medications involved, as well as the client's response and outcome.

Choice D Reason: Obtaining blood for coagulation studies is important but not the priority action for the nurse because it does not provide immediate intervention or treatment for the client. The nurse should obtain blood

samples for coagulation studies, such as prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT), after notifying the healthcare provider and following their orders. The results of these tests can help determine the extent of anticoagulation and guide further therapy.

Choice A Reason: Choosing to send another nurse who is more receptive is not a good option, as it may create

resentment and conflict among the staff. The older nurse may feel discriminated against or excluded, and the other nurse may feel burdened or pressured. The nurse manager should try to engage and motivate the older nurse to attend the in-service session, as it is important for her professional development and patient safety.

Choice B Reason: Asking the nurse why she thinks there is no need for an in-service program about these emergencies may sound confrontational or accusatory and may put the nurse on the defensive. The nurse manager should avoid making assumptions or judgments about the nurse's attitude or beliefs, and instead try to understand her perspective and address any barriers or misconceptions.

Choice C Reason: Informing the older nurse that inservice is not optional and her scheduled attendance is mandatory may be true, but it may also sound authoritarian or coercive, and may undermine the nurse's autonomy or dignity. The nurse-manager should avoid using threats or ultimatums, and instead try to explain the rationale and benefits of the inservice session, and solicit the nurse's input or feedback.

Choice D Reason: Encouraging the nurse to share her concerns and discuss ways to prepare for such emergencies is the best option, as it shows respect and empathy for the nurse, and fosters a collaborative and supportive

relationship. The nurse-manager should use active listening and open-ended questions, and provide relevant information and resources to help the nurse overcome her fears or doubts, and enhance her confidence and competence.