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The night charge nurse is making assignments for the next shift. Which client is most appropriate to assign to a nurse with less than a year of experience who is floated from the orthopedic unit to the medical unit? 1. Client newly admitted for an evolving ischemic stroke. 2. Client newly diagnosed with diabetes mellitus who needs insulin administration teaching. 3. Client with exacerbation of chronic obstructive pulmonary disease (COPD) with a new tracheostomy. 4. Client with sickle cell crisis who requires frequent intravenous (IV) opioid medication for pain - CORRECT ANSWER-4. Client with sickle cell crisis who requires frequent intravenous (IV) opioid medication for pain. Sickle cell crisis is managed with IV hydration, frequent IV pain medication, and as-needed blood transfusion. Many orthopedic clients require medication with opioids to control pain, IV fluids, and blood transfusion (blood loss with surgery/trauma). The float nurse is familiar with the policies and procedures for pain assessment and administering opioid medications, which should be the same on non-specialty units within the same facility. (Option 1) The client newly admitted for an evolving ischemic stroke is best assigned to an experienced nurse who regularly works on the unit. The nurse will perform baseline and frequent follow-up neurologic assessments to determine if the client's condition is worsening. (Option 2) The client newly diagnosed with diabetes mellitus who needs insulin administration teaching is best assigned to a nurse who regularly works on the unit. The nurse would be familiar with the location of diabetic teaching materials, documentation procedure, and referral resources, and would be better able to evaluate the client's understanding and performance of insulin administration the next day. (Option 3) The client with exacerbation of COPD with a new tracheostomy is best assigned to an experienced nurse who regularly works on the unit. Care of a new tracheostomy requires
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