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Difficulty: HardClient Care Assignments and Collaboration

During a morning shift on a surgical unit, a practical nurse receives a client assignment that includes preparing an individual for an upcoming elective procedure. The care team also includes a registered nurse and an assistive personnel. Which of the following actions by the practical nurse represent appropriate scope of practice and collaboration? (Select all that apply.)

  1. Delegating the assistive personnel to obtain and document the client's preoperative vital signs.Answer
  2. B
    Explaining the surgical procedure's risks and alternative treatments to the client prior to consent.
  3. Signing the informed consent document solely as a witness to the client's voluntary signature.Answer
  4. D
    Administering a prescribed preoperative intravenous (IV) push sedative medication.
  5. E
    Discussing the details of the client's upcoming procedure with the care team in the facility's public cafeteria.
  6. Reinforcing the preoperative fasting instructions that were initially provided by the registered nurse.Answer

Answer

The correct actions include delegating the collection of preoperative vital signs to the assistive personnel, acting as a witness for the informed consent signature, and reinforcing the preoperative fasting instructions that were already taught by the registered nurse.
The practical nurse operates within a defined scope of practice that includes delegating stable, routine tasks (such as vital signs) to assistive personnel. The practical nurse may participate in the informed consent process by witnessing the client's signature, confirming it was given voluntarily. Furthermore, they are authorized to reinforce educational plans and instructions that have already been initiated by the registered nurse.

Step-by-Step Solution

1
Analyze the practical nurse's role in delegation.
Determined that delegating routine, non-invasive tasks like vital signs to assistive personnel is appropriate.
Assistive personnel are trained to gather basic, stable clinical data without requiring nursing judgment.
2
Differentiate the practical nurse's role in the informed consent process.
Determined that the nurse acts only as a witness to the signature, while the provider must explain the actual risks and benefits.
Explaining surgical risks requires advanced medical knowledge and is strictly the responsibility of the performing provider.
3
Evaluate the scope of practice regarding medication administration and education.
Identified that IV push medications and initial comprehensive teaching are beyond the practical nurse scope, but reinforcing existing teaching is allowed.
Intravenous push medications and initial education require the comprehensive assessment skills of a registered nurse.
4
Apply confidentiality standards to clinical collaboration.
Recognized that discussing client details in a public cafeteria is inappropriate.
Patient privacy laws dictate that clinical discussions must occur in private areas to prevent unintentional disclosure.

Key Concept

Scope of practice for the practical nurse regarding delegation, informed consent, client education, and confidentiality.
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Topics

Client Care Assignments and Collaboration

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