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Zorluk: Çok zorClient Care Assignments and Collaboration

A float Licensed Practical Nurse (LPN) has just arrived for a shift on an acute medical-surgical unit. The charge nurse hands the LPN a list of proposed client assignments. Which client assignment must the LPN immediately question and decline because it falls outside the legal scope of practice?

  1. A client admitted 2 hours ago with a fractured femur who has become increasingly restless, reports a sudden onset of dyspnea, and exhibits a new petechial rash on the upper chestCevap
  2. B
    A client with advanced Alzheimer's disease who exhibits baseline nocturnal wandering and requires the application of a bed alarm, scheduled toileting, and frequent safety checks
  3. C
    A client with a documented stage 3 pressure injury on the sacrum who requires a complex sterile wet-to-dry dressing change, wound irrigation, and reinforcement of a dietician's nutritional plan
  4. D
    A client scheduled for an elective procedure who has already discussed the risks with the surgeon and now requires a nurse to verify their identity and witness their signature on the informed consent document

Cevap

The client with a fractured femur who is exhibiting restlessness, dyspnea, and a petechial rash.
The client with a fractured femur who suddenly develops restlessness, dyspnea, and a petechial rash is exhibiting classic signs of fat embolism syndrome (FES), a life-threatening medical emergency. This client is acutely unstable and requires immediate, comprehensive assessment and advanced clinical judgment, which are strictly within the Registered Nurse (RN) scope of practice. The LPN must recognize this instability and decline the assignment.

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1
Analyze the role and scope of practice of the Licensed Practical Nurse (LPN) in client assignments.
LPNs care for clients with stable, predictable outcomes and perform tasks with established procedures. Unstable clients or those requiring comprehensive initial assessments must be assigned to an RN.
Identifying the boundaries of the LPN scope of practice is essential for safe delegation and assignment acceptance.
2
Evaluate the stability and acuity of each client described in the options.
The client with Alzheimer's disease, the client with a pressure injury, and the client needing a consent witness are all stable with predictable, chronic, or routine needs. The client with a femur fracture is showing sudden respiratory and neurological changes.
Determining client stability is the primary factor in deciding if an assignment is appropriate for an LPN.
3
Identify the underlying complication for the unstable client and determine the required level of care.
The client with a fractured femur is exhibiting the classic triad of fat embolism syndrome (respiratory distress, neurological changes like restlessness, and a petechial rash). This is an acute medical emergency requiring immediate RN-level assessment and intervention.
Recognizing life-threatening complications ensures the LPN knows when to immediately escalate care and decline unsafe assignments.

Anahtar Kavram

Delegation and Scope of Practice for the LPN/VN: Unstable Clients
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Konular

Client Care Assignments and Collaboration

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