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A licensed practical/vocational nurse (LPN/VN) is caring for a patient with stage 2 chronic kidney disease. Which observation by the RN requires an intervention?

A. The LPN/VN assists the patient to ambulate in the hallway.
B. The LPN/VN administers the erythropoietin subcutaneously.
C. The LPN/VN administers the iron supplement and phosphate binder with lunch.
D. The LPN/VN carries a tray containing low-protein foods into the patient's room.

1 Answer

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Final answer:

The observation requiring intervention is when the LPN/VN administers the iron supplement and phosphate binder with lunch, due to potential interactions and issues with absorption that could adversely affect the patient with chronic kidney disease.

Step-by-step explanation:

The observation by the RN that requires an intervention for a patient with stage 2 chronic kidney disease (CKD) is C. The LPN/VN administers the iron supplement and phosphate binder with lunch. This practice could be an issue because phosphate binders are typically taken with meals to effectively bind dietary phosphate, and iron supplements are usually absorbed best on an empty stomach. Furthermore, certain iron supplements can decrease the effectiveness of phosphate binders when taken concurrently, complicating the management of mineral and bone disorder in CKD patients.

It is important to note that while LPNs/VNs can assist in many aspects of patient care under the direct supervision of a registered nurse, including ambulating patients, administering certain medications like erythropoietin, and providing nutritional support through low-protein diets, attention must be given to the timing and combination of medications due to potential interactions and to maximize their therapeutic effects.

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