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Difficulty: MediumClient Care Assignments and Collaboration

An oncoming practical nurse (PN) is receiving the morning shift report on a pulmonary medicine floor. The nursing supervisor has distributed several tasks to the PN. Which of the following activities should the PN accept as appropriate and within their legal scope of practice? Select all that apply.

  1. Providing routine tracheostomy care and suctioning for a stable client who has a long-term tracheostomyAnswer
  2. B
    Detailing the potential complications of a bedside thoracentesis before the client signs the procedural consent form
  3. Administering scheduled oral levofloxacin to a client recovering from community-acquired pneumoniaAnswer
  4. D
    Pushing intravenous (IV) methylprednisolone for a client experiencing an acute exacerbation of asthma
  5. E
    Discussing a client's respiratory status and treatment plan with a visiting neighbor who asks about the prognosis
  6. Collecting a morning sputum specimen for culture and sensitivity testing from a client with suspected bacterial bronchitisAnswer

Answer

The practical nurse should accept providing routine tracheostomy care for a stable client, administering scheduled oral antibiotics, and collecting a sputum specimen.
The practical nurse (PN) scope of practice encompasses caring for stable clients with predictable health outcomes, administering routine oral medications, performing standard procedures on established airways (like chronic tracheostomy care), and collecting specimens. Therefore, providing tracheostomy care for a stable client, administering oral levofloxacin, and collecting a sputum specimen are all appropriate tasks for the PN to accept.

Step-by-Step Solution

1
Evaluate each assigned task against the legal scope of practice for a practical nurse (PN).
Identify tasks involving stable clients, basic procedural care, and standard medication administration.
The PN scope of practice focuses on clients with predictable outcomes and relies on established nursing protocols.
2
Identify tasks that require complex assessment, IV push medications, or provider responsibilities.
Determine that pushing IV medications during an acute exacerbation and detailing procedural complications are outside the PN scope.
IV push medications for unstable clients require RN-level comprehensive assessment. Explaining procedural risks is strictly the provider's duty.
3
Assess tasks for ethical and legal compliance regarding client privacy.
Recognize that sharing medical information with a neighbor violates healthcare privacy laws.
Nurses must strictly maintain client confidentiality and share information only with authorized individuals.

Key Concept

Delegation and Practical Nurse (PN) Scope of Practice
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Topics

Client Care Assignments and Collaboration

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