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Difficulty: MediumAssignment, Delegation and Supervision

A charge nurse on a progressive care unit is organizing the shift assignment for an experienced licensed practical nurse (LPN). Which of the following client assignments is most appropriate to delegate to the LPN?

  1. A client who is 3 days post-operative from a partial colectomy and requires the administration of scheduled oral analgesics and reinforcement of an existing sterile abdominal dressing.Answer
  2. B
    A client admitted 2 hours ago with an acute exacerbation of chronic obstructive pulmonary disease (COPD) who is exhibiting new-onset confusion and a respiratory rate of 28 breaths per minute.
  3. C
    A client with a newly established colostomy who requires an initial assessment of the stoma and development of a home care management plan.
  4. D
    A client preparing for discharge following a deep vein thrombosis who requires primary instruction on the self-administration of subcutaneous enoxaparin.

Answer

The client who is 3 days post-operative requiring oral analgesics and dressing reinforcement is the most appropriate assignment.
The correct answer identifies a stable client with predictable outcomes requiring routine tasks (oral medications, dressing reinforcement) that fit perfectly within the established scope of practice for an LPN.

Step-by-Step Solution

1
Evaluate the stability and acuity of each client described in the options.
Three clients require complex care (unstable COPD, new stoma assessment, primary discharge teaching) while one client is stable with predictable needs.
Delegation principles dictate that LPNs should be assigned clients with stable, predictable conditions.
2
Analyze the specific nursing tasks required for each client against the LPN scope of practice.
Initial assessment, care plan development, primary teaching, and caring for unstable clients are strictly RN responsibilities. Administering oral medications and reinforcing dressings fall within the LPN scope.
The RN cannot delegate tasks involving the nursing process (EAT: Evaluation, Assessment, Teaching) or advanced clinical judgment.

Key Concept

Delegation to Licensed Practical Nurses (LPNs)
Estimated Time:1m 15s
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Topics

Assignment, Delegation and Supervision

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