The practical nurse (PN) applies and then releases pressure to a client’s fingernail as seen in the photo. Normal nail color returns in 2 seconds. Which action should the PN take?
A.
Report abnormal findings to the charge nurse.
B.
Observe for blanching of the nailbed.
C.
Repeat the process with a different nailbed.
D.
Document the capillary refill time.
The correct action the practical nurse (PN) should take is:
D. Document the capillary refill time
Capillary refill time is a quick test used to assess peripheral perfusion and circulatory status. A refill time of 2 seconds or less is considered normal, so the PN should document this finding.