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Zorluk: ZorClient Care Assignments and Collaboration

A practical nurse (PN) is assigned to care for a group of clients on a busy medical-surgical unit. The PN is collaborating with a registered nurse (RN) and assistive personnel (AP). Which of the following actions by the PN demonstrate appropriate adherence to the legal scope of practice and safe delegation principles? Select all that apply.

  1. Requesting the RN to evaluate a client whose blood pressure has acutely decreased following the administration of an antihypertensive medicationCevap
  2. Administering a scheduled intramuscular analgesic to a stable client who is 24 hours post-appendectomyCevap
  3. Reinforcing the RN's initial education regarding the proper application and maintenance of a continuous positive airway pressure (CPAP) maskCevap
  4. D
    Assigning the AP to assist with feeding a client who was admitted yesterday with a stroke and is currently experiencing acute dysphagia
  5. E
    Explaining the potential complications and alternatives of a procedure to a client prior to witnessing the surgical consent form
  6. F
    Discussing a client's airborne isolation status with the AP in the public hospital cafeteria to ensure the AP wears an N95 respirator

Cevap

The correct actions include requesting the RN to evaluate the client with acutely decreased blood pressure, administering the scheduled intramuscular analgesic to the stable post-operative client, and reinforcing the RN's initial CPAP education.
The correct actions demonstrate a clear understanding of the boundaries of practical nursing. The PN correctly identifies that acute hypotension requires RN evaluation, safely administers a routine medication to a stable post-operative client, and appropriately reinforces teaching that was initially provided by the RN.

Adım Adım Çözüm

1
Analyze each action to determine if it falls within the legal scope of practice for a Practical Nurse (PN).
Identified that routine medication administration and reinforcement of teaching are appropriate PN tasks.
The PN role involves providing care to stable clients with predictable outcomes and reinforcing established care plans.
2
Evaluate the clinical stability of the clients involved in each scenario.
Identified that the client with dropping blood pressure and the client with acute dysphagia are unstable or require complex care.
Unstable clients require RN-level comprehensive assessment, and high-risk tasks (like feeding a dysphagic client) cannot be delegated to assistive personnel (AP).
3
Assess the delegation and collaboration decisions against ethical and legal standards.
Identified that explaining surgical risks violates the nurse's role in informed consent, and discussing patient data in a cafeteria violates confidentiality.
Providers must obtain informed consent, and health information must only be discussed in private, secure areas.

Anahtar Kavram

The practical nurse must consistently differentiate between stable clients appropriate for PN care and unstable clients requiring RN intervention, while adhering strictly to delegation rules, confidentiality laws, and boundaries regarding informed consent.
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Client Care Assignments and Collaboration

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