A nurse from the pediatric unit has been temporarily assigned to the ED. Which client would be most appropriate for this nurse to care for first?

• A. Neonate with fever and lethargy.
• B. HIV positive patient reporting nausea and vomiting.
• C. Child with severe asthma attack.
• D. Adult trauma patient with uncontrolled bleeding.

Answer: (B)

When a nurse from pediatrics is temporarily in the ED, the first assignment should match the nurse’s current scope of practice and the patient’s stability. This means starting with a patient whose needs are within pediatric nursing capabilities and who is not in immediate life-threatening jeopardy, while the ED handles the more time-sensitive or specialized cases.

The HIV-positive patient with nausea and vomiting is the best fit because their condition is likely stable and can be evaluated and monitored with standard nursing assessment, IV fluids, and symptom management. The other scenarios carry higher immediacy or require skills beyond what a pediatric nurse in ED training typically provides: a neonate with fever and lethargy could indicate sepsis and may deteriorate quickly; a child in a severe asthma attack often needs rapid airway management and advanced pediatric respiratory care; an adult trauma patient with uncontrolled bleeding requires immediate trauma resuscitation and procedures that exceed pediatric scope.

So, starting with the stable, non-acute HIV-positive patient aligns with the nurse’s training while ensuring patient safety, and the ED team can take over the more urgent cases.