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A POLST document specifies current treatment preferences like CPR or intubation for seriously ill clients, not future surrogate designation. It is completed with a provider and focuses on immediate medical interventions rather than naming a decision-maker.

A living will is a written statement expressing a client's wishes regarding life-sustaining treatments, but it does not appoint a surrogate decision-maker. The partner cannot complete one on the client's behalf, as the client must execute it while competent.

A DNR prescription is a provider's order to withhold CPR in the event of cardiac arrest. This does not address the client's need to designate a surrogate for all future healthcare decisions, only a single, acute intervention.

A 24-gauge IV catheter is too small for blood products due to its narrow lumen, which increases hemolysis risk from mechanical trauma and shear stress on RBCs during infusion. A 20- or 18-gauge catheter is typically recommended.

Filterless IV tubing lacks a microaggregate filter, which is essential to trap fibrin clots, platelet aggregates, and cellular debris that can form in stored blood. Using filterless tubing would allow these particles to enter the client's circulation.

Blood should not be placed in a warmer for 1 hour unless specifically ordered for a rapid massive transfusion. Prolonged warming can cause hemolysis and reduces the viability of RBCs; blood should infuse within 4 hours at room temperature.

Providing a mask for each visitor is not cost-effective and is unnecessary for contact isolation, which requires gowns and gloves for transmission of organisms via direct or indirect contact, not airborne or droplet precautions.

Stocking the room with a 2-day supply of disposable diapers is wasteful and not cost-effective because isolation rooms have limited storage, and unused supplies are discarded after discharge, leading to unnecessary expense.

Returning unopened equipment to the supply center is not appropriate for items already in the isolation room due to infection control protocols, as they are considered contaminated and cannot be restocked for other clients.
 

PCA delivers a prescribed bolus dose only when the lockout interval has elapsed; pressing the button repeatedly within the lockout period delivers no medication, so the client does not receive medication any time they press.

Only the client should press the PCA button because proxy dosing by a partner bypasses the patient’s own pain assessment and sedation monitoring, increasing the risk of respiratory depression and fatal overdose.

The PCA pump incorporates safety features including lockout intervals and dose limits; when used correctly by the patient, it reduces rather than increases the risk of overdose compared to intermittent boluses.

Calcium is essential for bone and tooth development and neuromuscular function, but it does not influence neural tube closure. Adequate calcium intake is important for maternal skeletal health but not for preventing neural tube defects.

Iron is necessary for hemoglobin synthesis and prevention of maternal anemia, supporting oxygen delivery to the fetus. However, iron deficiency does not cause neural tube defects, so it is not the primary nutrient for this prevention.

Zinc is a cofactor for numerous enzymes involved in growth and immune function, but its deficiency is not directly linked to neural tube defects. While zinc is important for overall fetal development, folate is the specific preventive nutrient.

Placing oral suction equipment at the bedside is a safety intervention for clients at high risk for aspiration or excessive secretions, not a primary intervention for delirium management. It does not address the underlying cognitive distortion or disorientation characteristic of this condition.

Alternating caregivers is discouraged in delirium care because it increases confusion and disorientation. Consistent caregivers promote familiarity, trust, and a stable environment, which are crucial for reorienting the client and reducing anxiety, thereby minimizing acute behavioral disturbances.

Atomoxetine is a selective norepinephrine reuptake inhibitor used primarily for attention-deficit/hyperactivity disorder, not for delirium. It has no approved indication for managing acute confusion or its symptoms, and its stimulant properties could potentially worsen agitation in this population.

Scheduling a disaster drill is a primary prevention activity. It is a proactive educational and preparatory step taken before a disaster occurs to improve readiness and response capabilities, but it does not directly involve intervening during the disaster event itself.

Identifying vulnerable populations is a primary prevention strategy. This occurs during the pre-disaster planning phase to identify those at high risk, such as the elderly or disabled, so that resources can be allocated, but it is not an active response during the crisis.

Referring disaster survivors to mental health counseling is a tertiary prevention intervention. It occurs after the acute disaster phase to rehabilitate and support survivors, addressing long-term psychological sequelae like post-traumatic stress disorder, and is not part of the immediate emergency response.

Drainage tubes are generally removed when output is low, typically ≤20-30 mL per 24 hours, often after 3-5 days, not 24 hours post-op. Removing it too early risks fluid accumulation (seroma) at the surgical site, impairing healing and increasing infection risk.

The supine position is not preferred post-mastectomy as it can cause tension on the incision. The client should be placed in a semi-Fowler's position with the arm on the operative side elevated on pillows to promote lymphatic drainage and reduce edema.

A drainage output of 25 mL in 24 hours is within the expected normal range and does not require notification. The provider is usually notified for outputs >75-100 mL in 24 hours or sudden increases in drainage, which may indicate bleeding or infection.

Relaxation techniques are a therapeutic intervention to reduce anxiety and work of breathing. However, they are implemented after a comprehensive assessment of the dyspnea's cause, as they do not address physiological issues like secretions, obstruction, or hypoxia that may require immediate action.

Administering a low dose of opioid medication (e.g., morphine) is an effective pharmacological intervention for dyspnea, as it reduces respiratory drive and anxiety. However, it is an intervention step and should only be given after a thorough assessment to rule out reversible causes.

Changing the client's position is a non-pharmacological intervention that can improve ventilation-perfusion matching and reduce dyspnea. While effective, it is still an intervention that follows the initial assessment to determine if the client can be repositioned safely and if it is appropriate.