Question

The patient presents to the ER with nausea and vomiting for the past 4 hours. He feels tired and confused, and feel short of breath. The patient tells the physician that he had been on a cruise for the past week and returned late last evening. He felt tired and slightly nauseous this morning but went out to eat a pancake breakfast with his girlfriend. He returned home and began vomiting and feeling short of breath. Examination it was determined that the patient had fruity-smelling breath. A serum blood glucose was ordered and resulted at 560 mg/dl. The patient was given 12 units of Insulin Regular Human in the ER. Recheck of a finger stick blood glucose resulted in 272 mg/dl.

The patient admitted to the Med/Surg floor for frequent blood glucose monitoring and a possible Insulin IV drip. RN delegated finger stick blood glucose monitoring to a nursing assistant. Nursing was observed getting a finger stick blood glucose without wearing gloves and throwing the sharp lancet in the trash can.

In reference to the patient's scenario, what (if any) unsafe practices should the nurse report and possibly intervene?

Answer 1

The nurse has to report about the nursing assistant's unsafe practice of not wearing the gloves and inappropriate disposal of sharp needles. From patient's perspective, it puts the patient in risk of nosocomial infections as his immunity is compromised from diabetic ketoacidosis and he needs to be pricked often to monitor his blood glucose levels.

From the prospective of nursing assistant, he / she is at risk of needle prick injuries and blood contamination.

Improperly disposed sharp needles puts risk of needle prick injuries to people who handle trash . Therefore, many are affected by the action of nursing assistant and the nurse in charge has to report this and intervene so that this action is not repeated.

Thank you.