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Difficulty: MediumAssignment, Delegation and Supervision

During a morning shift on a pulmonary care unit, a registered nurse (RN) is dividing client care tasks among a licensed practical nurse (LPN/VN) and an unlicensed assistive personnel (UAP). Which of the following tasks should the RN assign to the LPN/VN?

  1. Administering scheduled oral and inhaled bronchodilators to a clinically stable client with chronic obstructive pulmonary disease (COPD)Answer
  2. B
    Completing the admission assessment for a newly arrived client transferred from the emergency department with an acute asthma exacerbation
  3. C
    Creating a discharge education plan for a client newly prescribed a home continuous positive airway pressure (CPAP) device
  4. D
    Evaluating the effectiveness of intravenous corticosteroids administered to a client experiencing acute respiratory distress

Answer

The task involving the administration of scheduled oral and inhaled bronchodilators to a clinically stable client with COPD.
The correct answer involves administering scheduled oral and inhaled bronchodilators to a clinically stable client with COPD. LPN/VNs are trained and licensed to administer routine, non-intravenous medications to clients who have chronic, stable conditions with predictable outcomes.

Step-by-Step Solution

1
Analyze each proposed task against the NCSBN delegation model and the specific scope of practice for an LPN/VN.
Identify that the LPN/VN can safely perform routine medication administration for stable clients, but cannot perform initial assessments, initial teaching, or evaluation of unstable clients.
Safe delegation requires ensuring the right task is assigned to the right person based on their educational preparation and legal scope of practice.
2
Evaluate the clinical acuity of each client described in the options.
The client with chronic COPD is clinically stable, making routine medication administration safe and appropriate for the LPN/VN. The other clients are unstable, newly admitted, or require new comprehensive education.
The RN must retain care for unstable clients and tasks requiring advanced clinical judgment, delegating only predictable and stable tasks.

Key Concept

Delegation of tasks to LPN/VN based on scope of practice
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Topics

Assignment, Delegation and Supervision

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