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Difficulty: MediumClient Care Assignments and Collaboration

Due to an unexpected staffing shortage on a urology unit, the nursing supervisor is redistributing assignments. Which client is most appropriate for the practical nurse (PN) to accept into their care?

  1. A client who is three days post-nephrectomy, has stable vital signs, and requires a routine sterile dressing change.Answer
  2. B
    A client who returned from a percutaneous renal biopsy 15 minutes ago and is reporting sudden, severe back pain.
  3. C
    A client who was just admitted with acute kidney injury and requires an initial comprehensive nursing assessment.
  4. D
    A client who needs a detailed explanation of surgical risks and alternative treatments before signing a procedural consent form.

Answer

The most appropriate client for the PN to accept is the one who is three days post-nephrectomy, has stable vital signs, and requires a routine sterile dressing change.
The practical nurse (PN) is trained to care for stable clients with predictable outcomes. A client who is three days post-nephrectomy with stable vital signs fits this criterion. Furthermore, performing a routine sterile dressing change is a standard technical skill well within the legal scope of PN practice.

Step-by-Step Solution

1
Evaluate the stability and needs of the client requiring a sterile dressing change.
The client is three days postoperative, has stable vital signs, and requires an established, routine procedure.
The practical nurse (PN) scope of practice encompasses caring for clients with stable, predictable conditions and performing routine therapeutic tasks such as sterile dressing changes.
2
Evaluate the client reporting severe back pain after a renal biopsy.
The client is exhibiting acute, unstable changes that indicate a potential severe complication like retroperitoneal hemorrhage.
Unstable clients with changing conditions require the advanced clinical judgment and assessment skills of a registered nurse (RN).
3
Evaluate the newly admitted client with acute kidney injury.
The client requires an admission history and physical assessment.
Initial comprehensive assessments and care plan formulation are strictly within the RN's scope of practice.
4
Evaluate the client requiring a detailed explanation for informed consent.
The client requires an explanation of surgical risks and alternatives.
It is the provider's legal responsibility to explain the procedure and its risks. The nurse's role is solely to witness the client's signature.

Key Concept

Scope of Practice: The practical nurse (PN) safely cares for stable clients with predictable outcomes, while registered nurses (RNs) manage unstable clients and initial assessments. Providers are responsible for explaining procedures for consent.
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Topics

Client Care Assignments and Collaboration

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