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RN Nursing · Delegation and Supervision · Practice question

A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?

Answer & explanation

Correct: A primigravida client who is 1 day postoperative following a cesarean birth and has a PCA pump.

When a float nurse from a medical-surgical unit is assigned to an obstetrical unit, the charge nurse must match the client's needs to the float nurse's competency. A primigravida who is one day postoperative following a cesarean birth and has a patient-controlled analgesia pump represents the most appropriate assignment for a medical-surgical float nurse. This client's care — postoperative monitoring, pain management, PCA assessment, wound care, and vital signs — closely mirrors competencies a medical-surgical nurse uses daily. A client with gestational diabetes receiving biweekly nonstress tests requires interpretation of fetal surveillance testing, which is specialized obstetrical knowledge not typically within a medical-surgical nurse's scope. A multigravida with preeclampsia receiving misoprostol for labor induction is high-acuity and requires expertise in obstetrical pharmacology, fetal monitoring, and recognition of eclampsia — inappropriate for a float nurse. A client at 32 weeks with premature rupture of membranes requires monitoring for chorioamnionitis, preterm labor, and fetal compromise, all requiring obstetrical expertise. The postoperative cesarean client's needs are most congruent with the medical-surgical nurse's existing skill set, making this the safest and most appropriate assignment.

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