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Question

Difficulty: HardClient Care Assignments and Collaboration

While providing care on a high-acuity step-down unit, a licensed practical/vocational nurse (LPN/VN) must prioritize various clinical demands. Which of the following actions by the LPN/VN is legally appropriate and within their scope of practice?

  1. A
    Modifying the nursing care plan to include new impaired gas exchange interventions for a client who suddenly developed dyspnea
  2. Reinforcing previously taught infection control guidelines with a client preparing for discharge with a central venous catheterAnswer
  3. C
    Clarifying the specific surgical risks and alternative treatment options for a client before asking them to sign a procedure consent form
  4. D
    Providing a telephone update regarding a client's postoperative status to a caller who verbally identifies themselves as the client's sibling

Answer

The legally appropriate action is reinforcing previously taught infection control guidelines with a client preparing for discharge with a central venous catheter.
Reinforcing previously established education is within the LPN/VN scope of practice. The RN is responsible for the initial teaching and assessment of the client's learning needs, while the LPN/VN safely reinforces this information to promote client understanding and safe care prior to discharge.

Step-by-Step Solution

1
Evaluate the LPN/VN's role in client education and discharge planning.
The initial teaching and assessment of learning needs must be performed by the Registered Nurse (RN), but the LPN/VN can safely reinforce this established education.
This distinguishes the LPN/VN's data collection and reinforcement role from the RN's comprehensive teaching and evaluation role.
2
Analyze the LPN/VN's scope regarding unstable clients and care plan modifications.
A client developing sudden dyspnea is unstable. The LPN/VN cannot independently formulate or modify the care plan for new acute issues.
Acute changes in condition require immediate escalation for a comprehensive RN assessment and clinical judgment.
3
Assess the nurse's legal responsibility during the informed consent process.
The nurse acts only as a witness to ensure the signature is authentic and voluntary.
Explaining surgical risks and alternative treatments is strictly the responsibility of the healthcare provider performing the procedure.
4
Review confidentiality and HIPAA standards regarding sharing protected health information.
Information cannot be shared over the phone based merely on verbal claims of relation.
The facility's privacy protocols (such as verifying a passcode) must be followed to prevent an unintentional confidentiality breach.

Key Concept

LPN/VN Scope of Practice, Delegation, and Legal Responsibilities
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Topics

Client Care Assignments and Collaboration

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