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Difficulty: MediumAssignment, Delegation and Supervision

During the morning huddle on a busy neurology step-down unit, the charge nurse is distributing client assignments to a team comprising registered nurses (RNs), licensed practical nurses (LPNs), and unlicensed assistive personnel (UAPs). Which client is the most appropriate assignment for the LPN?

  1. A
    A client who was admitted 2 hours ago with an acute ischemic stroke and requires continuous neurological monitoring.
  2. A client with a chronic traumatic brain injury who requires routine enteral tube feedings and scheduled oral medications.Answer
  3. C
    A client with multiple sclerosis who requires initial education on self-administering subcutaneous medication.
  4. D
    A client with myasthenia gravis who is newly reporting difficulty swallowing and progressive muscle weakness.

Answer

The client with a chronic traumatic brain injury requiring routine enteral tube feedings and scheduled oral medications.
The correct answer identifies a client with a stable, chronic condition requiring predictable interventions. Administering routine enteral feedings and oral medications falls safely within the authorized scope of practice for a Licensed Practical Nurse (LPN).

Step-by-Step Solution

1
Analyze the needs of each client to determine stability and acuity.
Three clients are either unstable, newly admitted, or requiring initial education. One client is stable with predictable needs.
Safe delegation requires matching the client's condition and complexity of care with the caregiver's authorized scope of practice.
2
Apply the principles of delegation (the 'EAT' acronym - Evaluate, Assess, Teach).
The RN must retain clients requiring initial assessment, continuous monitoring, and initial teaching.
LPNs cannot perform initial teaching or complex clinical assessments on unstable clients.
3
Identify the task within the LPN scope of practice.
Routine enteral feedings and oral medications for a stable client can be assigned to the LPN.
LPNs are trained and licensed to administer medications and perform routine procedures on stable clients with predictable outcomes.

Key Concept

Delegation to Licensed Practical Nurses (LPNs) involves assigning stable clients with predictable outcomes, while avoiding tasks requiring complex assessment, clinical judgment, or initial teaching.
Estimated Time:1m 30s
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Topics

Assignment, Delegation and Supervision

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