An RN who usually works in a spinal rehabilitation unit is floated to the emergency department.
Which of these clients should the charge nurse assign to this RN?
- A- A middle-aged client who says “I took too many diet pills” and “my heart feels like it is racing out of my chest.”
- B- A young adult who says “I hear songs from heaven. I need money for beer. I quit drinking two (2) days ago for my family. Why are my arms and legs jerking?”
- C- An adolescent who has been on pain medications terminal cancer with an initial assessment finding pupils and a relaxed respiratory rate of 10,
- D- An elderly client who reports having taken a “large crack hit” 10 minutes prior to walking into the emergency room.
Answer: C:
An adolescent who has been on pain medications for terminal cancer with an initial assessment finding of pinpoint pupils and a relaxed respiratory rate of 10
Nurses who are floated to other units should be assigned to a client who has minimal anticipated immediate complications of their problem. The client in option C exhibits opioid toxicity with the pinpoint pupils and has the least risk of complications to occur in the near future.
Nurses who are floated to other units should be assigned to a client who has minimal anticipated immediate complications of their problem. The client in option C exhibits opioid toxicity with the pinpoint pupils and has the least risk of complications to occur in the near future.
The most appropriate client for the charge nurse to assign to the RN who usually works in a spinal rehabilitation unit is:
C. An adolescent who has been on pain medications for terminal cancer with an initial assessment finding pupils and a relaxed respiratory rate of 10.
Here's why:
- Client C's condition is potentially stable:
While terminal cancer is a serious condition, the initial assessment of normal pupils and a relaxed respiratory rate suggests a relatively stable situation. This aligns with the RN's experience in spinal rehabilitation, which often involves managing stable chronic conditions.
- Client C's needs may not require specialized emergency care:
The initial assessment doesn't raise immediate red flags for acute emergencies requiring specialized emergency department (ED) expertise. The RN's rehabilitation background could be valuable for managing pain and monitoring the patient's comfort.
- Other clients present more complex or urgent situations:
- A and D: Both involve potential overdoses requiring immediate medical intervention and specialized ED management.
- B: This client presents with potential withdrawal symptoms and mental health concerns, which might require different expertise than spinal rehabilitation.
Therefore, assigning Client C to the RN from spinal rehabilitation allows them to utilize their skills in managing chronic conditions while minimizing exposure to potentially overwhelming or complex cases in the busy ED environment.
It's important to note that this is a general recommendation based on the limited information provided. The charge nurse should ultimately consider all available information, including the RN's specific skills and experience, to make the most appropriate assignment for each client's needs and the overall functioning of the ED.
