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Difficulty: MediumAssignment, Delegation and Supervision

A nursing team consisting of a registered nurse (RN) and a licensed practical/vocational nurse (LPN/VN) is preparing to begin their shift on a busy urology and general surgery floor. After receiving the handoff report, the RN must coordinate the client assignments.

Which client is most appropriate for the RN to assign to the LPN/VN?

  1. A client who underwent an open appendectomy three days ago and requires a scheduled sterile abdominal dressing change.Answer
  2. B
    A client who recently returned from a transurethral resection of the prostate and requires an initial assessment of their continuous bladder irrigation.
  3. C
    A client preparing for a scheduled nephrectomy who is requesting detailed information regarding the surgical risks and anticipated recovery timeline.
  4. D
    A client diagnosed with urosepsis whose mean arterial pressure has progressively decreased over the past two hours.

Answer

The client who underwent an open appendectomy three days ago and requires a scheduled sterile abdominal dressing change.
The correct assignment pairs a stable client who has predictable outcomes with a standard procedural task. A client who is three days post-appendectomy is generally stable, and performing a routine sterile dressing change falls safely and directly within the established scope of practice for an LPN/VN.

Step-by-Step Solution

1
Analyze the client status in each option to determine if they are considered stable or unstable.
The appendectomy client is stable. The post-prostatectomy client is newly postoperative and unstable. The nephrectomy client requires initial teaching. The urosepsis client is hemodynamically unstable.
LPN/VNs should only be assigned clients with stable conditions and predictable outcomes.
2
Evaluate the specific task required for each client against the RN and LPN/VN scope of practice.
Initial postoperative assessments and initial patient teaching cannot be delegated. Complex care for unstable clients must remain with the RN. Sterile dressing changes are an expected competency within the LPN/VN scope.
The RN cannot delegate tasks involving the core nursing process, including comprehensive assessment, planning, evaluation, and initial teaching.
3
Select the option that appropriately matches a stable client with a task suitable for the LPN/VN scope of practice.
The client requiring a routine sterile dressing change three days after an appendectomy is the only appropriate and safe assignment.
This assignment adheres strictly to the legal and professional principles of safe delegation.

Key Concept

Delegation of care to an LPN/VN requires assigning stable clients with predictable outcomes while the RN retains tasks involving initial assessment, clinical judgment, and initial teaching.
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Topics

Assignment, Delegation and Supervision

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