Re-assignments & Delegation

  1. HI,

    What is the reasoning you apply to questions like this one?
    It is about RNs being reassigned to a different ward.

    Thank you!

    The nurse cares for clients on the medical/surgical floor. Because of a staffing shortage, an RN has been reassigned from postpartum. Which of the following clients should the nurse give to the reassigned nurse?

    1. A client admitted with facial trauma after an auto accident.
    2. A client diagnosed with a heat stroke.
    3. A client having a systemic reaction to latex.
    4. A client with progressive systemic sclerosis experiencing Raynaud's phenomenon.
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    Specialty: 2 year(s) of experience


  3. by   blessedBSNRN
    I think is no. 2 being the least unstable of the 4
    1. Has facial trauma, I'll always remember that facial, neck, upper trunk involves airway esp. if burns / mva

    3. Unstable
    4. Usbtable

    My tips also for answering this kind of question is always think what unit is the nurse from? Is the client stable or not stable? Acute or chronic? It's the same thing as Prioritizarion! Good luck!
  4. by   Jen_Jen88
    I also believe it's 2. Its compared to the rest is the most stable.
  5. by   BSNbeDONE
    I would go with number 4 because this condition is most prevalent in women, which the nurse is more familiar with, and only requires that the patient be maintained at a warmer temperature and medications to dilate the blood stream. With this condition being Raynaud's the patient has had this disease for a long time, making it more of a chronic illness than an acute injury.
  6. by   nurseprnRN
    Systemic sclerosis isn't the least bit unstable. All the other three have fair to good chances of life-threatening complications: airway compromise (facial fracture), anaphylaxis (latex allergy), or shock (heat stroke), from conditions the postpartum nurse may not know well and complications of which she may not anticipate or recognize as they develop.

    Therefore the only safe delegation is the systemic sclerosis patient. If he gets sicker it's likely to be more slowly and less catastrophically, as systemic sclerosis is a slow, chronic condition. Note also that "Reynaud's" is not his diagnosis, it's a symptom of his systemic sclerosis, and it's not life-threatening in the least (though you can lose digits). It also doesn't matter a bit if the patient is male or female for purposes of this discussion, which is one reason they don't specify. Read more carefully.

    Note: Questions like this are very successful at weeding out people who are spooked by scary-sounding diagnoses because they don't know what they mean and don't read carefully. It's not just about delegation; it wants to know if you understand the possible complications.
    Last edit by nurseprnRN on Sep 16, '13
  7. by   nursemj24
    i think # 4.. 1,2,& 3 are unstable.. heat stroke may experience dehydration or shock.. 4 mostly seen in women..
  8. by   cmedar20
    It's definitely number 4. That's your most stable patient.
  9. by   LeeLeeTheGPN
    I agree with four. The fact that this process is progressive keys to me that this a chronic condition, experiencing an exacerbation, while although client requires monitoring, client is least unstable. Raynauds is usually non-life threatening.