A nursing assistive personnel (NAP) reports seeing a reddened ...

[Mimi]

A nursing assistive personnel (NAP) reports seeing a reddened area on the patient's hip while bathing the patient. Which action should the nurse take?
 
  a. Request a wound nurse consult.
  b. Go to the patient's room to assess the patient's skin.
  c. Document the finding per the NAP's report.
  d. Ask the NAP to apply a dressing over the reddened area.

Question 2

A patient with an indwelling urinary catheter has been given a bed bath by a new nursing assistive personnel. The nurse evaluating the cleanliness of the patient notices crusting at the urinary meatus. Which action should the nurse take next?
 
  a. Ask the nursing assistive personnel to observe while the nurse performs catheter care.
  b. Leave the room and ask the nursing assistive personnel to go back and perform proper catheter care.
  c. Tell the nursing assistive personnel that catheter care is sloppy.
  d. Remove the catheter.

[tmlewis4706]

Answer to Question 1

ANS: B
The nurse needs to assess the patient's skin. Assessment should not be delegated; it is the responsibility of the licensed registered nurse. The nurse needs to document the assessment findings objectively, not subjectively, per the nursing assistive personnel. Before requesting a consult or determining treatment, the nurse needs to assess the skin.

Answer to Question 2

ANS: A
If the staff member's performance is not satisfactory, give constructive and appropriate feedback. You may discover the need to review a procedure with staff and offer demonstration. Because the nursing assistant is new, it is best for the nurse to perform catheter care while the assistant observes. This action will ensure that the assistant has been shown the proper way to perform the task and fosters collaboration rather than leaving the room just to tell the assistant to come back. Telling that catheter care is sloppy does not correct the problem. The catheter does not need to be removed.

[Mimi]

TYSM

[tanna.moeller]

Excellent