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Difficulty: MediumClient Care Assignments and Collaboration

A registered nurse (RN) charge nurse is delegating care tasks to a licensed practical/vocational nurse (LPN/VN) on a medical-surgical unit. Which of the following client care activities should the LPN/VN accept as within their scope of practice? (Select all that apply.)

  1. A
    Formulating the initial nursing care plan for a client admitted with an acute exacerbation of chronic obstructive pulmonary disease
  2. Administering a scheduled intramuscular analgesic to a client who is 24 hours postoperative following an appendectomyAnswer
  3. C
    Administering an intravenous (IV) push antiarrhythmic medication to a client experiencing new-onset atrial fibrillation
  4. Reinforcing previous dietary teaching for a client with type 2 diabetes mellitus who is preparing for dischargeAnswer
  5. E
    Evaluating the effectiveness of a newly implemented pain management protocol for a client with sickle cell crisis
  6. Performing a sterile dressing change for a client with a healing abdominal surgical incisionAnswer

Answer

The LPN/VN should accept the tasks of administering a scheduled intramuscular analgesic, reinforcing previous dietary teaching, and performing a sterile dressing change.
The licensed practical/vocational nurse (LPN/VN) scope of practice includes providing care for stable clients with predictable outcomes. Routine medication administration (including intramuscular injections), reinforcing teaching that was initially developed and provided by a registered nurse (RN), and performing specific technical procedures like sterile dressing changes are all safely within the LPN/VN legal scope of practice.

Step-by-Step Solution

1
Identify the role and scope of practice of the LPN/VN compared to the RN.
The RN is responsible for initial assessments, nursing diagnoses, formulating care plans, initial teaching, and evaluating care. The LPN/VN assists with data collection, performs routine procedures, administers standard medications, and reinforces teaching.
Understanding these legal and regulatory boundaries is essential to determine which delegated tasks are appropriate to accept.
2
Analyze each task for complexity, stability of the client, and required clinical judgment.
Formulating initial care plans, administering IV push cardiac medications to unstable clients, and evaluating new protocols require advanced RN clinical judgment. Routine IM medications, reinforcing teaching, and sterile dressing changes for stable clients do not.
The five rights of delegation dictate that tasks must involve predictable outcomes and not require independent nursing evaluation.
3
Select only the tasks that align with the LPN/VN scope of practice.
The tasks involving routine IM analgesics, reinforcing dietary teaching, and performing a sterile dressing change are selected as correct.
These activities involve predictable care for stable clients and do not require the comprehensive assessment or evaluation reserved for the RN.

Key Concept

Delegation and LPN/VN Scope of Practice
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Topics

Client Care Assignments and Collaboration

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