Question

You are the nurse assigned to this group of patients. There are 2 RN’s (one is you: the charge nurse and a staff member, plus another RN), and you have an LPN and 2 nursing assistants. Plan your day/ evening. What tasks/ skills can be delegated to the LPN and the aid?

Patient/ allergy	Name	Report	Vitals	Mediations	Orders	Labs	Priority	Delegate LPN NA	RN 1 RN 2
Pt #1	Jennifer Hoffman	33-year-old female present to the Emergency Department. Has a history of asthma, with several ED visits in the last year. Presents anxious, coughing and chest tightness Peak Flow levels are decreasing Tracheostomy tube placed during last admission 3 months ago	Vitals RR: 30 BP 138/84 HR: 92 Sat 89% RA	Albuterol 2.5 mg/ 2.5 ml via trach Solumedrol 100 mg IV available 125 mg/2ml NSS 80 ml/hr Epi Pen prn	Trach care q shift
Pt/ Allergy	Name	Report	Vitals	Medications	Orders	Labs	Priority	Delegate LPN NA	RN1 RN 2
Pt#3	Skyler Hanson	18 –year- old male in diabetic ketoacidosis three days ago. Transferred to the medical surgical floor after being in the ICU for three days. He had been on an Insulin drip and received IV hydration.	RR: 18 BP 118/74 HR:78 Sat 99% RA	D5W 150 ml/hr NPH insulin 22 units SQ Novalog Insulin 6 units SQ	1800 ADA diet Urine for ketones NKA	Blood Glucose 650
Pt#4 Sulfa	Doris Bowman	Patient is a 39-year-old who underwent a total abdominal hysterectomy with bilateral salpingoopherectomy. Tolerated the procedure well. Postoperative day 2. She has an abdominal incision covered with a 4x4 gauze dressing. Foley draining 200 ml clear yellow output. Arrives back from x-ray unresponsive.	RR: 12 BP 124/84 HR: 92 Sat 88% RA	LR 125 ml/hr Morphine Sulfate 2 mg IVP for pain Ondansetron hydrochloride (Zofran) 4 mg IVP Naloxone hydrochloride (Narcan) 0.4 mg/ml IVP PRN for sedation		WNL

Answer 1

Patient# 1: Jeniffer Hoffaman

Responsibilities of a LPN:

* Monitor Vital signs Second hourly

* Collecting blood sample for ABG analysis

* Providing Tracheotomy Care and check the patency

* Providing psychological and emotional support

* Providing Nebulization 4 th hourly

* Administering medication as per the physician orders

Responsibilities of Nursing Aid:

* Providing comfort to the patient

* Removing tight clothes

*Providing adequate ventilation

* sending samples to the laboratory as early as possible

* Arranging instruments for tracheotomy care

* Collecting the blood report and informing the higher personnel

Patient#2 :

LPN:

* Monitor vital signs

* Closely Monitor blood glucose level with glucometer and inform physician if required

* Administer Intravenous medications as ordered

* Follow physician prescription for medication

* Observe for complications of ketoacidosis

*Keep ready diet plan for ketoacidosis patient

* Monitor Input and output chart

Assistant Nurses:

* Change clothing and provide patient attire

* Send blood samples to the lab

*Encouraging to be positive and motivated

* Monitor for proper diet for the patient

* always accompany the patient while using toilet

Patient #3:

LPN:

1. Monitor Vital Signs and check level of consciousness

2. Measure urine output hourly

3. Maintain Nil per oral unless doctors prescribe

4. Measure abdominal girth before feed

5. Ask for subjective symptoms like bloating

6 Observe the gauze over the site for bleeding

Nursing Aids:

* Drain the urinal every hour and documenting the amount

* Observe for bleeding over the site

* Check for motion or bleeding