The practical nurse (PN) is auscultating a client’s heart sounds. Which heart sounds are considered abnormal findings that should be reported to the charge nurse?

A. "Place a 'Do Not Resuscitate' sign outside the client's door and at the bedside."
A DNR order must be written by the healthcare provider and documented in the medical record. A sign alone is not sufficient to ensure the client’s wishes are followed.

B. "Reassure the client that life-saving measures will not be taken without consent."
While reassuring the client is important, the client’s wishes must be documented formally through an advance directive, which is legally binding and ensures that medical staff are aware of and follow the client’s instructions.

C. "Complete an advance directive form and place it in the medical record."
While completing an advance directive is important, the first priority is notifying the healthcare provider so that the client’s wishes can be documented and the proper legal forms can be completed.

D. "Notify the client's healthcare provider of the client's wishes as soon as possible."
The nurse should immediately notify the healthcare provider of the client’s wishes. The healthcare provider can then initiate the appropriate legal documentation, such as a DNR order or an advance directive, ensuring the client’s wishes are respected in the future. This is the first step in ensuring that the client’s preferences are followed.

Verifying the completion of all new prescriptions is crucial because it ensures that necessary medications or treatments are not delayed or missed for the clients. By reviewing the new prescriptions, the PN can ensure that any necessary medications or treatments are ordered and completed as required. This task takes priority because it directly impacts the immediate care and well-being of the clients.
While the other tasks mentioned are also important, they are not as time-sensitive or critical as verifying the completion of new prescriptions:
A. "Clean up and organize the nurses' work-station": While maintaining a clean and organized work-station is important for efficiency and safety, it can be done after the more critical tasks have been completed.
B. "Write a narrative shift summary for each client": Providing shift summaries is important for effective communication and continuity of care, but it can be done after ensuring the completion of new prescriptions, as it involves documenting and reviewing the events and assessments that occurred during the shift.
C. "Calculate and record intake and output totals": Tracking intake and output is important for assessing fluid balance, but it can also be done after verifying the completion of new prescriptions, as it involves documenting and calculating fluid volumes.