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Difficulty: MediumAssignment, Delegation and Supervision

A nursing care team on a busy postoperative unit consists of a registered nurse (RN), a licensed practical/vocational nurse (LPN/VN), and an unlicensed assistive personnel (UAP). When distributing the workload for the shift, which of the following task assignments is the most appropriate?

  1. Assigning the LPN/VN to administer scheduled oral analgesics and reinforce routine wound care instructions for a client who is two days post-appendectomy.Answer
  2. B
    Delegating the UAP to evaluate the swallowing ability of a client who recently suffered a transient ischemic attack before providing their breakfast tray.
  3. C
    Directing the LPN/VN to conduct the initial admission assessment and develop the plan of care for a client transferring from the emergency department.
  4. D
    Assigning the UAP to feed a client with suspected aspiration pneumonia who has just developed sudden shortness of breath and an oxygen saturation of 88%.

Answer

The most appropriate assignment is having the LPN/VN administer scheduled oral medications and reinforce teaching for a stable postoperative client.
The correct answer involves assigning a stable client to the LPN/VN for routine medication administration and teaching reinforcement. An LPN/VN is licensed to administer oral medications and can reinforce education that was initially provided by the RN. The client is two days post-operative, indicating a stable and predictable recovery trajectory.

Step-by-Step Solution

1
Analyze each proposed task against the legal scope of practice for RNs, LPN/VNs, and UAPs.
Identified that evaluation, initial assessment, care planning, and managing unstable clients are restricted to the RN.
Delegation must follow the Five Rights of Delegation, ensuring tasks match the caregiver's licensure and competency.
2
Evaluate the clinical stability of each client presented in the options.
The client with sudden shortness of breath is unstable; the client transferring from the ED requires baseline data; the postoperative appendectomy client is stable.
Only stable clients with predictable outcomes should be assigned to LPN/VNs or UAPs.
3
Select the option that appropriately matches a routine, predictable task with the correct personnel.
Assigning the stable, two-days post-operative client to the LPN/VN for medication administration and teaching reinforcement is selected as safe and appropriate.
This task falls within the LPN/VN scope of practice and involves a stable client.

Key Concept

The RN retains responsibility for the nursing process (assessment, diagnosis, planning, and evaluation), initial teaching, and the care of unstable clients. Safe delegation involves assigning tasks to LPN/VNs and UAPs that match their educational background and the client's stability.
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Assignment, Delegation and Supervision

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