The nurse has reviewed the Nurses' Notes, Vital Signs, and Laboratory Results from 3 months ago.

Exhibits

The nurse is reviewing the client's plan of care. Which of the following findings indicate the client's condition has improved? Select all that apply.

Rationale:

A. Evaluate why the client was not ambulated.: The first step in addressing a missed delegated task is to assess the reason it was not completed. Understanding whether barriers were related to the AP, client condition, workload, or communication helps the nurse plan corrective action and prevents recurrence.

B. Ambulate the client on behalf of the AP.: While ensuring the client’s needs are met is important, jumping straight to performing the task bypasses assessment of the underlying issue. Immediate action may address the symptom but not the cause of the missed delegation.

C. Supervise the AP performing the task.: Supervision is appropriate for ongoing tasks but is not the first action once a task has already been missed. The nurse must first determine why the task was not completed before implementing supervision.

D. Remind the AP of her assigned tasks.: Reminding the AP without assessing why the task was missed does not address potential systemic or situational barriers. It may be necessary later but is not the initial step in problem resolution.

Rationale:

A. Respiratory rate: The client’s respiratory rate decreased from 20/min to 18/min, indicating improved cardiopulmonary function and reduced physiological stress, which reflects overall improvement in health status.

B. Pain level: The client’s pain level remains at 0/10 both at baseline and follow-up, showing no change. Pain was not a concern initially, so this does not indicate improvement.

C. Blood pressure: Blood pressure decreased from 164/92 mm Hg to 138/84 mm Hg, demonstrating better hypertension management through lifestyle modifications and/or medications, indicating cardiovascular improvement.

D. LDL: LDL cholesterol improved significantly from 220 mg/dL to 90 mg/dL, reflecting effective hyperlipidemia management and reduced risk for cardiovascular disease.

E. Weight: The client’s weight decreased from 88.6 kg to 83.2 kg, reducing BMI from 30.5 to 28.7. This weight loss indicates successful lifestyle modifications and improvement in overall metabolic health.

F. Hemoglobin A1c: HbA1c decreased from 7% to 6%, showing improved long-term glycemic control and reduced risk for diabetes-related complications, reflecting an overall improvement in metabolic health.