Question

The clients with the cast, toe amputation, and arthritis are in stable condition and need ongoing assessment and pain management that are within the scope of practice of an LPN/LVN under the supervision of an RN. The RN should take responsibility for preoperative teaching, and the client with terminal cancer needs a comprehensive assessment to determine the reason for refusal of medication. The client with trauma needs serial assessments to detect occult trauma.

A. Preoperative teaching is within the scope of practice for an LPN/LVN.

B. Comprehensive assessment is not necessary for a client with terminal cancer.

C. Serial assessments are unnecessary for a client with trauma.

D. Ongoing assessment and pain management are not within the scope of practice for an LPN/LVN.

Answer 1

LPN/LVNs can manage ongoing assessment and pain management under RN supervision but more complex tasks, including preoperative teaching and comprehensive assessments of serious conditions, are the RN's responsibility. Clinical focus on patient care involves identifying and treating localized infections promptly and effectively.

Step-by-step explanation:

The question pertains to the scope of practice for LPN/LVNs and RNs in a hospital setting, particularly regarding a scenario where multiple patients with different conditions require care that varies in complexity. An LPN/LVN, under the direct supervision of a registered nurse, can focus on providing dialysis treatments and ongoing assessment and pain management for stable patients. This involves tasks such as taking and reporting vital signs and preparing equipment for sterile procedures. However, more complex duties, such as preoperative teaching and comprehensive assessments for clients with terminal cancer or those with potential occult trauma, typically fall within the RN's scope of practice.

In the clinical focus scenario provided, Barbara, a patient with metastatic inflammatory breast cancer, demonstrates symptoms suggestive of a localized infection at the site of her central venous catheter. The physician's response involves a topical antiseptic treatment and a fresh dressing application along with prescribing antibiotics. Such clinical decisions and actions align with the appropriate standards of care for addressing infections associated with catheter sites.