HESI Case Study - Management of a Surgical Unit 100% Pass

HESI Case Study - Management of a Surgical Unit 100% Pass How should Ms. Hatch respond to this situation? Request that a night shift staff RN go to the room to evaluate the situation. The night charge nurse states "That UAP is incompetent." As the day shit charge nurse, how should Ms. Hatch respond? Your concern needs to be addressed with the unit manager In making initial client care assignments, which client can be assigned to a PN, rather than an RN? A 2-day postoperative client with an abdominal incision and a Jackson-Pratt drain. A day shift nurse will be 30min late. How should the nurse's client care assignments be manages until the nurse arrives? Assign an additional client to each of the day shift staff nurses Which additional client should be assigned to the same PN? A client: Experiencing hypo active bowel sounds on the second postoperative day after a colon resection. (As this is a expected finding.) When making initial rounds, the charge nurse should see which client first? A postoperative client with a tracheostomy who has signs of a tracheoesophageal fistula. Client with syncope needs to go to bathroom, and... How should the charge nurse respond to this information? Asses the client with the possible fistula while the PN assists the other client to the restroom The drainage bag for the client with continuous bladder irrigation is full, but there's no urine return in the tubing. The bladder is distended and client reports severe bladder pain. How should Ms. Hatch delegate tasks to respond to this situation? While the RN manually irrigates the tubing, the UAP can empty the urine drainage bag. Preop client with prolonged PTT is lethargic with pale, diaphoretic skin. The client's BP is 70/40. When assisting the nurse to care for this client, the UAP should be assigned which task? Position the client as directed. The HCP prescribes an immediate transfusion of packed RBCs. After the nurse obtains the first unit of blood, what task can be delegated to the UAP? Obtain the client's vital signs and report the results to the nurse before the transfusion is started. Which action should the nurse implement? Hold the tray and contact the surgeon for clarification of the client's preoperative needs. Client reports to RN that she feels uneasy about the procedure. What is the best initial response by the nurse? Tell me what is making you feel uneasy. Which finding in a postoperative client warrants an immediate change in care assignments, so that an RN assumes care of that client rather than the PN who has assign initially? Dyspnea and a cough that produces frothy, white sputum Which client should be reassigned to the PN? A postoperative client: Needing an indwelling urinary catheter after surgery PN has never inserted a catheter in a male client. Which action should the charge nurse implement? Go with the PN to supervise the procedure Which task may be delegated to the UAP? Apply the client's antiembolism (TED) stockings. The RN observes the TED stockings are below knees. UAP states client must have pulled them down. How should the primary nurse respond? Let's work together to reapply the stockings while I talk to the client about the purpose of TEDS. Ms. Hatch overhears RN assign UAP to take vitals and report back any problems. How should Ms. Hatch respond? Advise the primary nurse of the responsibility to review all vial signs obtained by the UAP. What approach should Ms. Hatch use when introducing this change? Explain the need to implement the change in policy. How should Ms. Hatch respond? I will bring your concern to the attention of the wound are team. Post op client has a cold pack, the skin under is pale and client reports that the cold pack has been in place for >4 hrs. After removing the pack, what action should Ms. Hatch take next? Consult with the primary nurse caring for the client. How should Ms. Hatch respond to the nurse? You are responsible for monitoring tasks delegated to the UAP. What action should Ms. Hatch implement to aid in the resolution of the conflict between the UAP and the primary nurse? Encourage both staff members to practice effective communication with one another. The postoperative client with which condition is most safe to transfer to the skilled care unit? Knee surgery requiring continuous use of passive motion therapy. How should the charge nurse best utilize available staff during the process of transferring one client to the skilled care unit, while admitting another client awaiting emergency surgery? The UAP can assist the PN in transferring the client to the skilled care unit while the RN admits the client awaiting emergency surgery.