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Zorluk: Çok zorAssignment, Delegation and Supervision

Amidst a staffing shortage on a high-acuity medical-surgical ward, a registered nurse (RN) is coordinating care with one licensed practical nurse (LPN/VN) and one unlicensed assistive personnel (UAP). The RN must safely delegate interventions while managing a highly complex client census. Which delegation decision by the RN is the most legally and clinically appropriate?

  1. Assigning the LPN/VN to perform a sterile dressing change and administer a scheduled dose of oral sevelamer to a client with end-stage renal disease.Cevap
  2. B
    Instructing the UAP to feed a client with amyotrophic lateral sclerosis (ALS) who is demonstrating a new onset of a weak, wet-sounding cough during liquid intake.
  3. C
    Directing the LPN/VN to perform the initial evaluation of a client reporting sudden, sharp chest pain and diaphoresis, while the RN completes discharge paperwork.
  4. D
    Delegating the UAP to evaluate whether a postoperative client is correctly returning the demonstration of incentive spirometry techniques.

Cevap

The most appropriate delegation is assigning the LPN/VN to perform the sterile dressing change and administer the oral medication to the client with end-stage renal disease.
Assigning the LPN/VN to perform a sterile dressing change and administer oral sevelamer to a client with end-stage renal disease is correct because both tasks fall safely within the LPN/VN scope of practice. The client is described with a chronic, expected condition without signs of acute instability, making this a legally sound and clinically safe delegation choice.

Adım Adım Çözüm

1
Analyze each delegation option against the rights of delegation and core nursing scope of practice principles.
Identify which tasks require RN clinical judgment (Evaluate, Assess, Teach) and which can be safely delegated.
To ensure legal compliance and maintain client safety during care delivery.
2
Evaluate the clinical acuity and stability of the clients described in each scenario.
Identify unstable clients or those experiencing acute physiological changes (e.g., new wet cough, sudden chest pain).
Unstable clients or those with sudden changes require the advanced assessment skills of a Registered Nurse.
3
Determine the appropriate scope for the LPN/VN and UAP based on the identified client needs.
Confirm that sterile procedures and routine oral medications on stable clients fall within the LPN/VN scope, while evaluation, initial assessment, and care of unstable clients do not.
To select the single legally and clinically appropriate delegation option.

Anahtar Kavram

Delegation and Scope of Practice in Complex Clinical Scenarios
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Konular

Assignment, Delegation and Supervision

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