Which intervention is the most important for the practical nurse (PN) to implement when applying an ice pack to a client?

The PN should instruct the UAP to observe and report any ear drainage after removing the device, as this may indicate an infection or irritation of the ear canal. The PN should also instruct the UAP to verify that the device is labeled with client's identification, as this can prevent mix-ups or misplacement of the device. The PN should also instruct the UAP to remove ear wax from the device's surface, as this can improve the sound quality and prevent damage to the device.

The other options are not correct because:

a. Keeping the battery door closed during storage is not a correct instruction, as it can drain the battery and shorten its life span. The PN should instruct the UAP to keep the battery door open during storage, as this can conserve the battery power and prevent corrosion.

c. Storing the device on the window sill to prevent loss is not a correct instruction, as it can expose the device to heat, moisture, or sunlight, which can damage its components or affect its function. The PN should instruct the UAP to store the device in a dry, cool, and safe place, such as a case or a drawer.

Heart rate of 90 beats per minute with premature ventricular contractions (PVCs) noted on telemetry: This finding indicates an abnormality in the heart's electrical conduction system. PVCs are extra, abnormal heartbeats that originate in the ventricles. They can sometimes be benign, but they can also be associated with underlying heart conditions or electrolyte imbalances. Since the client is experiencing dizziness and tingling, which could be related to cardiac function, it is important to report this finding to the healthcare provider for further evaluation and appropriate management.

Incorrect:

A. Regular heart rate of 100 beats per minute on telemetry: This finding describes a heart rate within the normal range (60-100 beats per minute for adults). It does not indicate any immediate concerns or abnormalities that would require reporting to the healthcare provider in this context.
B. Hypoactive bowel sounds on assessment: Following a small bowel resection, it is common for bowel sounds to be temporarily reduced or absent due to the surgical manipulation and the bowel's response to anesthesia. Hypoactive bowel sounds alone do not directly relate to the client's reported symptoms of dizziness and tingling in digits, nor do they suggest an immediate need for reporting to the healthcare provider.
D. Hyperactive bowel sounds on assessment: Hyperactive bowel sounds, characterized by increased loudness and frequency, can occur due to conditions such as gastroenteritis or bowel obstruction. However, in the context of a client who has undergone a small bowel resection and is on NPO status, hyperactive bowel sounds would not be expected and may indicate a potential complication. While it is important to monitor and document this finding, it is not directly related to the client's reported symptoms and does not require immediate reporting to the healthcare provider in this scenario.