Question

The nurse is in the room of a client who is neutropenic. Which action by the nursing assistant, observed by the nurse, would indicate a need for action? A. Placing a Foley bag in the bed with the client when turning her B. Raising the head of the bed prior to feeding the client C. Adding pillows to the client's back area for support after turning and repositioning D. Providing mouth care to a client who is NPO

Short answer

Answer: Providing mouth care to a client who is NPO.

Step-by-step solution

Analyze the options

Let's go through each option and scrutinize it: A. Placing a Foley bag in the bed with the client when turning her B. Raising the head of the bed prior to feeding the client C. Adding pillows to the client's back area for support after turning and repositioning D. Providing mouth care to a client who is NPO

Rule out option A

A Foley bag (urinary catheter) in the bed when turning the client is not likely to cause harm or discomfort to the client. Also, a nursing assistant may be required to place a Foley bag while turning a patient, so this would not indicate the need for action by the nurse.

Rule out option B

Raising the head of the bed before feeding the client is a standard practice to prevent aspiration. This action is appropriate and would not indicate the need for action by the nurse.

Rule out option C

Adding pillows to provide support after turning and repositioning is also an appropriate action for a nursing assistant to do. This action ensures the patient's comfort and safety and would not indicate the need for action by the nurse.

Identify the correct answer

Providing mouth care to a client who is NPO (nothing by mouth) would be the correct answer (option D). While mouth care is essential, patients who are neutropenic are at a higher risk of infections. The nursing assistant should take extra precautions and possibly receive guidance from the nurse on providing mouth care to such patients. In conclusion, the correct answer is option D, which indicates a need for action by the nurse.

Key concepts

Neutropenic Patient Care

Caring for patients with neutropenia requires meticulous attention to infection prevention due to their compromised immune system. Neutropenia, a condition characterized by a low level of neutrophils, increases a patient's susceptibility to infections. For health care providers, including nursing assistants, this means employing strict aseptic techniques and being acutely aware of the risks associated with even minor procedures, such as mouth care.

In the context of mouth care for neutropenic patients, it's essential for nursing staff to be gentle to avoid causing abrasions that could serve as entry points for pathogens. They should use a soft-bristled toothbrush or sponge swabs and avoid alcohol-based mouthwashes that could irritate the mucous membranes. When providing such care, it might be necessary for the nursing assistant to consult with the nurse to ensure that the specific needs and precautions for the neutropenic patient are meticulously followed, highlighting the need for supervision and potential intervention, as noted in the textbook exercise.

Nursing Assistant Responsibilities

Nursing assistants play a crucial role in patient care within healthcare settings, working under the supervision of nurses to provide essential, direct patient care. Their duties encompass a wide range of activities, from assisting with activities of daily living (ADLs) such as bathing, dressing, and eating to performing basic health tasks like taking vitals and positioning patients for comfort.

When it comes to the responsibilities of a nursing assistant, knowing when to enact a specific task and when to seek guidance is fundamental. For example, they may be allowed to turn a patient and provide comfort using pillows, as mentioned in the textbook solution. However, when it comes to patients with specific health conditions, such as those who are neutropenic, they must demonstrate a higher level of vigilance and possibly collaborate more closely with nurses to ensure that their interventions are safe and appropriate for the patient's condition.

Patient Safety in Nursing

Patient safety is the cornerstone of nursing practice. It involves the prevention of harm to patients and ensuring a secure environment for their care. Nurses, along with other healthcare providers, are responsible for creating a culture of safety that permeates every aspect of patient care, from hand hygiene to error prevention strategies.

For nursing assistants, adherence to protocols and standard operating procedures is essential to maintain patient safety. This adherence includes practices such as raising the head of the bed prior to feeding to prevent aspiration, as noted in the exercise solutions. Equally, they must be aware of the specific safety requirements for different patient populations, such as those who are immunocompromised. Continuous education, awareness of the patient's care plan, and an environment that encourages communication and question-asking contribute to a safe care environment for all patients.