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Difficulty: MediumAssignment, Delegation and Supervision

The registered nurse (RN) is planning care for a group of clients on an orthopedic trauma unit. The care team includes an experienced licensed practical nurse (LPN/VN) and an unlicensed assistive personnel (UAP). Which of the following tasks is most appropriate for the RN to delegate to the LPN/VN?

  1. A
    Reassessing the respiratory status and titrating oxygen therapy for a client who suddenly developed acute shortness of breath.
  2. B
    Developing a discharge teaching plan regarding pin site care for a client recovering from an external fixation procedure.
  3. Administering scheduled oral muscle relaxants and subcutaneous anticoagulants to a client who is 3 days post-spinal fusion.Answer
  4. D
    Conducting the initial admission nursing history and physical assessment for a client arriving from the emergency department with a fractured pelvis.

Answer

The most appropriate task to delegate to the LPN/VN is administering scheduled oral muscle relaxants and subcutaneous anticoagulants to a client who is 3 days post-spinal fusion.
The task of administering scheduled oral and subcutaneous medications to a stable client who is 3 days post-operative is appropriate for an LPN/VN. This client has predictable outcomes, and the task falls within the standard procedural skills and legal scope of practice of a practical/vocational nurse.

Step-by-Step Solution

1
Analyze the core principles of delegation.
Recall that RNs must not delegate tasks involving the nursing process, specifically Evaluation, Assessment, and Teaching (EAT), or complex clinical judgment.
Delegation decisions must adhere strictly to the legal scope of practice and the NCSBN guidelines to ensure client safety.
2
Evaluate the clinical stability of each client in the presented options.
Identify that the client with sudden shortness of breath and the newly admitted client from the ED are unstable or have unpredictable outcomes.
LPN/VNs should be assigned to care for stable clients with expected, predictable outcomes.
3
Determine which task matches the LPN/VN scope of practice.
Routine medication administration (oral, subcutaneous) for a stable, post-operative client is a safe and standard procedure for an LPN/VN.
This task does not require initial teaching, complex assessment, or independent clinical judgment.

Key Concept

Delegation and Scope of Practice (RN vs LPN/VN)
Estimated Time:1m 15s
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Topics

Assignment, Delegation and Supervision

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