Question

The RN observes an LPN/LVN carrying out all of the following actions while caring for a patient with stage 2 chronic kidney disease. Which action requires the RN to intervene?

a. The LPN/LVN administers erythropoietin subcutaneously.
b. The LPN/LVN assists the patient to ambulate in the hallway.
c. The LPN/LVN gives the iron supplement and phosphate binder with lunch.
d. The LPN/LVN carries a tray containing low-protein foods into the patient's room.

Answer 1

The RN must intervene when the LPN/LVN administers an iron supplement with a phosphate binder, as these medications should be taken at separate times to avoid reduced effectiveness.

Step-by-step explanation:

The RN would need to intervene when the LPN/LVN gives the iron supplement and phosphate binder with lunch. Iron supplements and phosphate binders should not be taken together as iron can interfere with the effectiveness of phosphate binders. These medications should be administered at different times to ensure optimal absorption and effectiveness. Ensuring proper administration of medications is critical in the management of chronic kidney disease (CKD).

While other actions such as administering erythropoietin subcutaneously, assisting the patient to ambulate, and providing a tray of low-protein foods are appropriate in the care of a patient with CKD, the simultaneous administration of iron supplements and phosphate binders requires correction. This intervention is part of ensuring accurate and sterile procedures as part of direct patient care under the direct supervision of a registered nurse.