A licensed practical/vocational nurse (LP/VN) is caring for a ...

[kshipps]

A licensed practical/vocational nurse (LP/VN) is caring for a resident who has orders providing supervised smoking of cigarettes in the smoking area. The LP/VN rounds and smells smoke.
 
  He enters the client's room and finds the resident sitting up in bed and smoking while on a nasal cannula at 2 L/minute of oxygen. He has caught the top blanket of two blankets on fire (a small area of the blanket, 3  2 inches). Which priority action should the nurse provide?
  A) Throw the full water pitcher onto the fire.
  B) Turn off the oxygen concentrator; grab the cigarette, and put it in the sink next to the bed with running water.
  C) Remove the blanket and place into sink with running water.
  D) Call for help and assess and treat client.

Question 2

A licensed practical/vocational nurse (LP/VN) enters a client's room, finding the bed in high position, both top-side rails down (which violate facility policy) and the call light within reach.
 
  There is a puddle of spilt bath water on the floor by the bed. The nurse recognizes that the unlicensed assistive personnel (UAP) stepped out of the room during the bath to gather some linen she forgot. Which action is the priority?
  A) Return the bed to low position and place top-side rails up
  B) Wipe up the spilled water
  C) Discuss the situation with the UAP
  D) Write an incident report

[djofnc]

Answer to Question 1

Ans: B
Feedback:
The first best action in the scenario is to turn off the oxygen concentrator because oxygen potentiates the flames and get rid of the source of flame, the cigarette. The next action is to dump the full water pitcher onto the fire. If the nurse tried to remove the blanket while it is on fire, the nurse risks injuring him/herself. The nurse can remove the top blanket and other blankets, and client gown, etc. and place the blanket that was on fire in the sink with running water to ensure it stays out. The nurse can call for help, assess, and treat the client using first aid per institution policy and procedure.

Answer to Question 2

Ans: A
Feedback:
The nurse's top priority is to provide a safe environment for the client first by working from client to surrounding environment. Step 1: Return the bed to low position and place top side rails up. Step 2: Wipe up the spilled water. Step 3: Discuss the situation with the UAP. (Rationale: The UAP stepped out and will return, so the nurse needs to privately discuss the situation with the UAP and reach an acceptable resolution to provide safe care for the client). Step 4: Write an incident report. (Rationale: Charting occurs after care is provided, and part of creating and maintaining the safe environment is step 3 input to include in the incident report).