A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?
A.
A client who has gestational diabetes and is receiving biweekly nonstress tests
B.
A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor
C.
A client who is at 32 weeks of gestation and has premature rupture of membranes
D.
A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump
The Correct answer and Explanation is:
The correct answer is D. A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump.
Explanation:
When considering which client to assign to a registered nurse (RN) who has floated from a medical-surgical unit, it’s crucial to evaluate the complexity of care required and the nurse’s existing skills and experience.
- Option A: A client who has gestational diabetes and is receiving biweekly nonstress tests – This client requires ongoing assessment of fetal well-being and management of diabetes. Although a medical-surgical nurse may understand diabetes management, the specifics of fetal monitoring and interpreting nonstress tests require specialized obstetric knowledge that a floated RN may not possess.
- Option B: A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor – This client is high-risk due to preeclampsia, a serious condition that necessitates careful monitoring and management. The complexities associated with preeclampsia and labor induction are better suited for an experienced obstetric nurse.
- Option C: A client who is at 32 weeks of gestation and has premature rupture of membranes – This situation is also high-risk, as the potential for infection and complications like preterm labor is significant. Care for this client requires knowledge of obstetric protocols and immediate response strategies, again likely beyond the expertise of a floated medical-surgical nurse.
- Option D: A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump – This client requires postoperative care, which is well within the scope of a medical-surgical nurse’s expertise. Management of pain control via a patient-controlled analgesia (PCA) pump, monitoring vital signs, and assessing for signs of infection are common nursing responsibilities that the floated RN will be familiar with. Since this care does not involve the complexities of obstetric-specific interventions, it represents a safer and more appropriate assignment for the floated nurse.
In conclusion, assigning the postoperative Cesarean section client (Option D) to the floated RN allows for safe patient care while utilizing the nurse’s existing skill set effectively.