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Difficulty: MediumClient Care Assignments and Collaboration

A nursing team consisting of a Registered Nurse (RN), a Practical Nurse (PN), and an Assistive Personnel (AP) is receiving client assignments on a medical-surgical unit. Match each client care activity to the most appropriate team member and rationale based on their legal scope of practice.

  • Performing an initial admission assessment on a client experiencing acute respiratory distress.Registered Nurse (RN), due to the requirement for comprehensive assessment of an unstable client.
  • Administering a scheduled oral antibiotic and performing a routine sterile dressing change.Practical Nurse (PN), due to the requirement for focused assessment and sterile skills on a stable client.
  • Providing a bed bath, oral care, and assisting with feeding for a client with chronic hemiparesis.Assistive Personnel (AP), due to the requirement for standard, unchanging activities of daily living.
  • Developing a comprehensive discharge teaching plan for a client with a new colostomy.Registered Nurse (RN), due to the requirement for the initial formulation of a teaching plan.

Answer

Assessment of the unstable client and initial teaching plan development are assigned to the RN. Routine medication administration and sterile dressing changes on a stable client are assigned to the PN. Basic hygiene and feeding for a chronic, stable client are delegated to the AP.
Safe delegation requires matching the complexity of the task and the stability of the client to the provider's scope of practice. The RN handles unstable clients, comprehensive assessments, and initial teaching. The PN manages stable clients, standard medication administration, and routine sterile procedures. The AP handles standard activities of daily living for stable clients.

Step-by-Step Solution

1
Analyze the acuity and stability of each client.
The client in respiratory distress is unstable. The post-operative client, the client with hemiparesis, and the client with a new colostomy are physiologically stable.
Client stability determines whether care requires the comprehensive assessment skills of an RN or the focused assessment skills of a PN.
2
Determine the complexity and scope of each task.
Initial assessment and care planning require an RN. Initial teaching requires an RN. Sterile dressing changes and oral medications require a licensed nurse (PN or RN). Routine hygiene and feeding do not require a license.
Tasks must be matched to the legal scope of practice for each team member.
3
Assign the most appropriate team member to each task based on the Five Rights of Delegation.
Unstable assessment matches to the RN. Initial teaching matches to the RN. Stable sterile dressing and oral medications match to the PN. Routine activities of daily living match to the AP.
This process ensures safe, effective, and legally compliant client care assignments.

Key Concept

Delegation and Scope of Practice Based on Client Acuity
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Topics

Client Care Assignments and Collaboration

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