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Difficulty: MediumClient Care Assignments and Collaboration

During the morning briefing on a specialized nephrology floor, client assignments are being determined for the nursing staff. Which of the following clients represents the most appropriate assignment for a practical nurse (PN)?

  1. A
    A client admitted two hours ago with acute pyelonephritis who requires an initial comprehensive physical assessment.
  2. B
    A client scheduled for a cystoscopy who is requesting further explanation about potential surgical complications before signing the consent form.
  3. A client with chronic kidney disease who is receiving scheduled oral phosphate binders and requires a daily weight measurement.Answer
  4. D
    A client with acute kidney injury who has a morning serum potassium level of 6.9 mEq/L and reports new onset palpitations.

Answer

The client with chronic kidney disease who is receiving scheduled oral phosphate binders and requires a daily weight measurement.
The correct answer identifies a stable client with a chronic condition requiring predictable, standard care. The administration of routine oral medications (such as phosphate binders) and the monitoring of daily weights are safely within the standard scope of practice for a practical nurse.

Step-by-Step Solution

1
Evaluate the stability and acuity of each client described in the options.
Three clients are unstable, require complex assessment, or need provider intervention. One client is stable with predictable, chronic needs.
The PN scope of practice is limited to caring for stable clients with expected outcomes.
2
Determine which specific nursing tasks are within the PN scope of practice.
Routine oral medication administration and daily weights are within the PN scope. Initial assessments, managing critical lab values, and explaining surgical risks are outside the PN scope.
Delegation and assignments must adhere to the legal and educational boundaries of the practical nurse's license.

Key Concept

Delegating and Assigning Client Care Based on Scope of Practice
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Topics

Client Care Assignments and Collaboration

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