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Difficulty: HardClient Care Assignments and Collaboration

A practical nurse (PN) is reviewing the shift assignment on a respiratory care unit. Which of the following delegated interventions are within the PN's legal scope of practice and should be ACCEPTED? Select all that apply.

  1. Reinforcing previous education on pursed-lip breathing techniques for a client with chronic obstructive pulmonary disease.Answer
  2. Performing sterile suctioning for a client with an established tracheostomy who is exhibiting coarse breath sounds.Answer
  3. Administering a scheduled oral antibiotic to a clinically stable client being treated for community-acquired pneumonia.Answer
  4. D
    Developing the initial nursing care plan for a client newly admitted with acute respiratory distress syndrome.
  5. E
    Evaluating a client's respiratory response immediately following the initiation of a continuous bronchodilator infusion for severe bronchospasm.
  6. F
    Explaining the procedural risks and potential complications of a scheduled bedside thoracentesis to obtain informed consent.

Answer

The PN should accept the tasks of reinforcing previous education on pursed-lip breathing, performing sterile suctioning for an established tracheostomy, and administering scheduled oral antibiotics to a stable client.
The practical nurse (PN) scope of practice is centered around providing care to clients with stable conditions and predictable outcomes. Reinforcing education initially provided by the RN, performing standard invasive procedures like tracheostomy suctioning on an established airway, and administering routine medications to stable clients are all safe and appropriate tasks for the PN to accept.

Step-by-Step Solution

1
Analyze the role and scope of practice of the practical nurse (PN) regarding client care assignments.
The PN scope includes caring for stable clients with predictable outcomes, performing routine procedures, gathering data, and reinforcing teaching.
Understanding legal boundaries is required to safely accept or decline delegated tasks.
2
Evaluate each assigned task against the PN scope of practice.
Teaching reinforcement, suctioning an established airway, and routine medication administration fit the criteria for PN delegation.
These tasks involve predictable outcomes and do not require comprehensive RN assessment.
3
Identify tasks that exceed the PN scope of practice to ensure they are declined and escalated.
Initial care plan development, evaluating unstable clients with severe bronchospasm, and explaining procedural risks fall outside the PN scope.
Initial assessment, evaluation of unstable clients, and obtaining informed consent require RN or provider-level licensure and judgment.

Key Concept

Practical Nurse Scope of Practice and Task Delegation
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Topics

Client Care Assignments and Collaboration

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