Emergency Nursing & Triage Q 4

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A client suffered an amputation of the first and second digits in a chainsaw accident. Which task should be delegated to an LPN/LVN?

  

    A. Cleansing the amputated digits and placing them directly into an ice slurry

    B. Wrapping the cleansed digits in saline-moistened gauze, sealing in a plastic container, and placing it in icy water

    C. Gently cleansing the amputated digits and the hand with povidone-iodine

    D. Cleansing the digits with sterile normal saline and placing it in a sterile cup with sterile normal saline

    

    

Correct Answer: B. Wrapping the cleansed digits in saline-moistened gauze, sealing in a plastic container, and placing it in icy water.

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Once a finger amputation has occurred, ischemic tolerance times are 12 hours if warm and up to 24 hours if cold. For more proximal amputations, these times are halved. The amputated part should be covered in a normal saline-soaked gauze, sealed in a plastic bag, and submerged in icy water with no direct contact with ice. If there is direct contact with ice, it could result in tissue damage and render the amputated part non-viable.

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Option A: The client is the center of care. The needs of the client must be competently met with the knowledge, skills, and abilities of the staff to meet these needs. In other words, the nurse who delegates aspects of care to other members of the nursing team must balance the needs of the client with the abilities of those to which the nurse is delegating tasks and aspects of care, among other things such as the scopes of practice and the policies and procedures within the particular healthcare facility.

Option C: Based on these characteristics and the total client needs for the group of clients that the registered nurse is responsible and accountable for, the registered nurse determines and analyzes all of the health care needs for a group of clients; the registered nurse delegates care that matches the skills of the person that the nurse is delegating to.

Option D: The job of the registered nurse is far from done after client care has been delegated to members of the nursing team. The delegated care must be followed up on and the staff members have to be supervised as they deliver care. The registered nurse remains responsible for and accountable for the quality, appropriateness, completeness, and timeliness of all of the care that is delivered.

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