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Zorluk: OrtaAssignment, Delegation and Supervision

An endocrinology unit is staffed by a registered nurse (RN), a licensed practical/vocational nurse (LPN/VN), and an unlicensed assistive personnel (UAP). The RN is reviewing the morning care requirements for four clients. Which client care activity is most safely delegated to the LPN/VN?

  1. A
    Performing the initial admission assessment for a client arriving from the emergency department with diabetic ketoacidosis.
  2. B
    Creating a dietary management and meal planning guide for a client newly diagnosed with type 1 diabetes mellitus.
  3. Administering routine subcutaneous insulin and changing a sterile heel ulcer dressing for a clinically stable client with type 2 diabetes.Cevap
  4. D
    Monitoring the rapidly changing neurological status of a client who is severely hypoglycemic and largely unresponsive.

Cevap

The most safely delegated task is administering routine subcutaneous insulin and changing a sterile heel ulcer dressing for a clinically stable client with type 2 diabetes.
Delegating the administration of routine subcutaneous insulin and a sterile dressing change for a stable client is correct because these tasks fall directly within the legal scope of practice for an LPN/VN. An LPN/VN is equipped to care for clinically stable clients with predictable health outcomes and perform technical skills such as medication administration and sterile procedures.

Adım Adım Çözüm

1
Analyze the staff mix and scope of practice constraints.
The team consists of an RN, an LPN/VN, and a UAP. The RN must retain tasks involving initial assessment, clinical judgment, initial teaching, and evaluation (often remembered by the acronym EAT).
Understanding the legal limitations of each role is necessary for safe delegation.
2
Evaluate each client vignette for stability and complexity.
The newly admitted client with DKA, the newly diagnosed client needing teaching, and the unresponsive hypoglycemic client are all unstable or require complex RN-level skills.
Unstable clients or those with unpredictable outcomes must be assigned to the RN.
3
Identify the task that matches the LPN/VN scope of practice.
The stable client needing routine medication and a sterile dressing change perfectly matches the LPN/VN capabilities.
LPN/VNs are trained to care for stable clients with predictable outcomes, administer standard medications, and perform sterile procedures.

Anahtar Kavram

Scope of practice and safe delegation principles for LPN/VNs.
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Assignment, Delegation and Supervision

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