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Difficulty: MediumAssignment, Delegation and Supervision

A registered nurse (RN) on a maternal-newborn unit is assigning client care to a licensed practical/vocational nurse (LPN/VN) and an unlicensed assistive personnel (UAP). Which client care assignment is most appropriate?

  1. Assigning the LPN/VN to care for a client who is 2 days postpartum and requires scheduled oral analgesics and observation of a healing cesarean incision.Answer
  2. B
    Delegating the UAP to perform the initial fundal massage and lochia check on a client who arrived from the delivery room 15 minutes ago.
  3. C
    Assigning the LPN/VN to provide the primary discharge education and newborn care instructions to a first-time mother.
  4. D
    Delegating the UAP to independently bottle-feed a newborn who has been experiencing frequent choking episodes and poor suck coordination.

Answer

Assigning the LPN/VN to care for a client who is 2 days postpartum and requires scheduled oral analgesics and observation of a healing cesarean incision.
Assigning an LPN/VN to administer routine oral medications and observe a healing incision for a stable, 2-day postpartum client aligns with the LPN/VN's scope of practice. The client has predictable outcomes and does not require complex RN-level assessment.

Step-by-Step Solution

1
Analyze each option to determine if the assigned task falls within the legal scope of practice for the designated personnel.
Identified that initial assessments, primary teaching, and care of unstable clients require RN skills.
The National Council of State Boards of Nursing (NCSBN) dictates that the RN cannot delegate assessment, clinical judgment, teaching, or evaluation (EAT).
2
Evaluate the stability and acuity of each client in the given scenarios.
The 2-day postpartum client is the only stable client with predictable outcomes assigned to appropriate personnel.
Delegation requires both the right task and the right circumstance, meaning the client must be stable.

Key Concept

Delegation based on stability and scope of practice
Estimated Time:1m 0s
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Topics

Assignment, Delegation and Supervision

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