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Difficulty: MediumAssignment, Delegation and Supervision

A nursing team on a medical-surgical floor is caring for a diverse group of clients. To optimize workflow while maintaining safety, the registered nurse (RN) must distribute client care activities among the team members. Which task is most appropriate for the RN to delegate to the licensed practical/vocational nurse (LPN/VN)?

  1. Administering a scheduled subcutaneous dose of enoxaparin to a stable client recovering from a total knee arthroplasty.Answer
  2. B
    Evaluating the respiratory status and lung sounds of a client who recently arrived from the emergency department with acute asthma.
  3. C
    Providing comprehensive discharge instructions regarding fluid restrictions to a client newly diagnosed with heart failure.
  4. D
    Developing an individualized plan of care for a client who requires complex wound management for a stage III pressure injury.

Answer

The most appropriate task is administering the scheduled subcutaneous enoxaparin to the stable postoperative client.
The correct answer identifies a task that perfectly aligns with the LPN/VN scope of practice. An LPN/VN is legally authorized to administer standard medications, including subcutaneous injections like enoxaparin, to clients whose conditions are stable and predictable.

Step-by-Step Solution

1
Review the established scope of practice for the Licensed Practical/Vocational Nurse (LPN/VN) under National Council of State Boards of Nursing (NCSBN) guidelines.
Identified that LPN/VNs can perform routine procedures, administer standard medications, and care for stable clients with predictable outcomes.
Delegation must align with legal scopes of practice to ensure client safety.
2
Apply the 'EAT' acronym (Evaluate, Assess, Teach) to eliminate tasks that the RN must retain.
Eliminated the options involving evaluating respiratory status, providing initial discharge teaching, and developing a care plan.
Tasks requiring initial assessment, complex clinical judgment, nursing diagnosis, and primary client education cannot be delegated to an LPN/VN or UAP.
3
Evaluate the remaining option for client stability and task predictability.
Selected the administration of subcutaneous enoxaparin.
The client is stable (recovering post-arthroplasty) and the intervention is a routine, predictable medication administration, making it a safe delegation.

Key Concept

Delegation of tasks based on the scope of practice and the EAT framework (RN retains Evaluation, Assessment, and Teaching).
Estimated Time:1m 0s
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Topics

Assignment, Delegation and Supervision

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