Fundamentals of Nursing Q 545
Which client(s) are appropriate to assign to the LPN/LVN, who will function under the supervision of the RN or team leader? Select all that apply.
A. A client who needs pre-op teaching for use of a PCA pump.
B. A client with a leg cast who needs neurologic checks and PRN hydrocodone.
C. A client post-op toe amputation with diabetic neuropathic pain.
D. A client with terminal cancer and severe pain who is refusing medication.
Correct Answer: B & C.
The clients with the cast and the toe amputation are stable clients and need ongoing assessment and pain management that are within the scope of practice for an LPN/LVN under the supervision of an RN. The RN should take responsibility for preoperative teaching, and terminal cancer needs a comprehensive assessment to determine the reason for refusal of medication.
Option A: Preoperative teaching is a nursing responsibility. Proper and appropriate assignments facilitate quality care. Improper and inappropriate assignments can lead to poor quality of care, disappointing outcomes of care, the jeopardization of client safety, and even legal consequences.
Option B: The clients with the cast are within the scope of practice for an LPN/LVN under the supervision of an RN. Delegation, simply defined, is the transfer of the nurse’s responsibility for the performance of a task to another nursing staff member while retaining accountability for the outcome. Responsibility can be delegated. Accountability cannot be delegated. The delegating registered nurse remains accountable for all client care despite the fact that some of these aspects of care can, and are, delegated to others.
Option C: The client with the toe amputation is a stable client and needs ongoing assessment and pain management that are within the scope of practice for an LPN/LVN under the supervision of an RN. The staff members’ levels of education, knowledge, past experiences, skills, abilities, and competencies are also evaluated and matched with the needs of all of the patients in the group of patients that will be cared for.
Option D: A client with terminal cancer and severe pain who is refusing medication is a nursing responsibility. Based on these characteristics and the total client needs for the group of clients that the registered nurse is responsible and accountable for, the registered nurse determines and analyzes all of the health care needs for a group of clients; the registered nurse delegates care that matches the skills of the person that the nurse is delegating to.