When planning team assignments for the shift, the charge nurse ...

[s.tung]

When planning team assignments for the shift, the charge nurse takes which of these as the first step?
 
  1. Determine how much work can be done by the charge nurse.
  2. Prioritize activities and available resources.
  3. Assign all the tasks in a fair, random manner.
  4. Ask the staff what assignments they prefer.

Question 2

The nurse is preparing a female client for discharge who will be prescribed Coumadin (warfarin) secondary to a diagnosis of thrombophlebitis. The nurse instructs the woman to:
 
  1. Stop taking oral contraceptives.
  2. Wear a peripad during menstruation and notify the doctor if the pad fills more than once an hour.
  3. Continue medication if she learns she is pregnant.
  4. Anticipate heavier-than-normal periods and call the doctor if bleeding continues for more than one week.

[T4T]

Answer to Question 1

2
Rationale: When planning team assignments, it is important to determine first what needs to be done, who is available to do it, and what the priorities are. After this is determined, the charge nurse can assign the tasks in a fair and reasonablenot randommanner.

Answer to Question 2

2
Rationale: The client taking anticoagulants might have heavier than normal periods, and should plan to use a peripad because it is impossible to determine amount of blood loss with a tampon. If the peripad fills more than once an hour, or hourly for more than two hours, the client should call her provider, because this is defined as heavy bleeding, and must be treated to prevent hemorrhagic shock. The physician will determine if oral contraceptives should be continued or changed to a different formula. Pregnancy should be avoided while on Coumadin (warfarin) because of the risk of fetal hemorrhage. Heavy bleeding should be reported immediately, not after a week.