Question

Case Study #4

Sarah Yandell, RN, a staff nurse on the medical-surgical floor of a large hospital, has just finished receiving report from the RN on the previous shift. As Sarah looks over her assignments for the day, she sees that the nurse manager has scheduled an LPN to float over from the postpartum unit. Sarah is assigned to supervise the LPN and orient her to the unit. Sarah also has a nursing assistant, with whom she has worked closely for longer than 8 months, assigned to work with her. Sarah reviews the tasks that must be accomplished for her seven assigned patients. Three patients are receiving intravenous antibiotics and need laboratory results monitored. A newly diagnosed diabetic patient will be discharged tomorrow and needs continued patient education about diabetes management. Two postoperative patients need dressing changes and assistance with ambulating. A post–cerebrovascular accident (CVA) patient with stable vital signs was just transferred from the medical intensive care unit and needs a nursing assessment and a care plan. The routine activities of patient assessments, updating care plans, taking vital signs, assisting with each patient's personal hygiene, giving scheduled and PRN medications, passing meal trays, stocking supply carts, and answering call lights also must be accomplished. In addition to all of these tasks, Sarah knows that she will have to spend time orienting the LVN to the unit.

1. When reviewing the tasks to be completed, what may Sarah NOT delegate to the LPN?
   1. Scheduled medications
   2. PRN medications
   3. IV medications
   4. Care of CVA patient
2. What level of supervision will be required?
   1. Unsupervised
   2. Periodic inspection
   3. Continuous supervision
   4. Continuous direction

3. What may Sarah NOT delegate to the nursing assistant?
   1. Care of the CVA patient
   2. Assisting patients with ambulation
   3. Personal hygiene of patients
   4. Retrieving lab reports
4. And what level of supervision will be required?
   1. Unsupervised
   2. Periodic inspection
   3. Continuous supervision
   4. Continuous direction
5. What patient care activities must be done by Sarah and may not be delegated to the LPN or the nursing assistant?
   1. Patient education
   2. Patient assessments
   3. Care plan updates
   4. All of the above

Answer 1

1) option "C" " IV medications"

Assuming LPN has experience in working with medical-surgical patients,Sarah may delegate scheduled and PRN medications to LPN.but except IV medications,this medications Sarah have to administer.Also delegate care tasks to CVA patient such as monitoring vital signs...

2) option "D" "continuous direction"

Sarah will provide continuous or frequent,direct supervision...because their working relationship is new.

3) option "A" "care of CVA patient"

Sarah may delegate the nursing assistant assisting patients with ambulation, retrieving lab reports and assisting patients with ambulation...but may not delegate the care of CVA patient

4) option "B" "periodic inspection"

Sarah will need to provide intial directions and periodic supervision for the nursing assistant...becuase they have 8 months of working relationship together.

5) option "D" "All of the above"

Sarah may not delegate these activities to LPN and nursing assistant...They are

Patient education ,patient assesments,care plan updates

All these activities will be done by Sarah.

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