Question

The nurse in the same day surgery unit assigns the unlicensed assistive personnel (UAP) to give a 1000 ml soap solution enema (SSE) to a client scheduled for an abdominal hysterectomy. Which statement by the nurse is most appropriate?

A) "Administer enemas until the results are clear."
B) "Give 3 enemas before surgery."
C) "Let me know the results of the enema."
D) "Slow the flow of the solution if cramping occurs."

Answer 1

The nurse should instruct the UAP to "Slow the flow of the solution if cramping occurs," as it focuses on patient safety and is within the UAP’s scope of practice. the correct answer is D.

Step-by-step explanation:

The most appropriate statement by the nurse in this scenario is "Slow the flow of the solution if cramping occurs." This instruction is an important safety measure, as it accounts for the comfort and the immediate response to potential adverse effects the patient may experience during the soap solution enema (SSE). Moreover, it implies that the unlicensed assistive personnel (UAP) is being trusted to monitor the patient for signs of discomfort, which seems within their scope of practice compared to evaluating the clarity of the results or determining the number of enemas needed, which may require clinical judgment beyond their role.

It's essential that the UAP understands the importance of regulating the flow to prevent or alleviate cramping and to communicate with the nurse regarding the patient's status during the procedure. This also reflects the health care team's commitment to patient safety and comfort, in line with the overall protocol that the surgical team, including nurses and anesthesia professionals, reviews key concerns for the patient's care both before and after surgery visibly and orally.