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Difficulty: MediumAssignment, Delegation and Supervision

The charge nurse on an inpatient respiratory unit is coordinating the care assignments for the upcoming shift. The nursing team includes registered nurses (RNs) and one experienced licensed practical/vocational nurse (LPN/VN). Which client is the most appropriate to assign to the LPN/VN?

  1. A
    A client admitted one hour ago with an acute asthma exacerbation who is receiving continuous albuterol nebulizer treatments.
  2. B
    A client recovering from a thoracentesis performed 30 minutes ago who requires initial post-procedure breath sound assessment.
  3. A client with chronic bronchitis who requires scheduled administration of oral corticosteroids and a routine metered-dose inhaler.Answer
  4. D
    A client preparing for discharge later today who requires instruction on how to independently manage a newly prescribed home oxygen system.

Answer

The client with chronic bronchitis requiring scheduled oral medications and a routine inhaler.
The most appropriate assignment for an LPN/VN is a client with a stable, chronic condition with expected outcomes who requires routine pharmacological interventions. Administering oral and inhaled medications to a stable client safely aligns with the LPN/VN scope of practice.

Step-by-Step Solution

1
Analyze the scope of practice for an LPN/VN.
An LPN/VN can care for stable clients with predictable outcomes and can administer standard medications (like oral and inhaled drugs).
Understanding professional boundaries is required for safe delegation.
2
Evaluate the stability and needs of each client.
The asthma client is unstable. The thoracentesis client needs initial assessment. The discharge client needs new teaching. The chronic bronchitis client is stable and needs routine care.
Applying the principles of 'Right Circumstance' and 'Right Task' to the scenarios.
3
Select the assignment that matches the LPN/VN scope of practice.
The stable client with chronic bronchitis is the correct assignment.
It avoids delegating assessment, teaching, or the care of unstable clients to the LPN/VN.

Key Concept

Delegation and Scope of Practice for LPN/VNs
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Topics

Assignment, Delegation and Supervision

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