The charge nurse is reviewing staff assignments for one Registered Nurse (RN) and one Licensed Practical/Vocational Nurse (LPN/VN) modification to ensure that the client and diagnosis are appropriate. See the exhibit. Select all that apply. | Room | Client and Diagnosis | Staff Assigned | |---|---|---| | 1 | 67-year-old receiving antibiotics for bacterial cystitis | Licensed Practical/Vocational Nurse | | 2 | 22-year-old three days post-operative laparoscopic appendectomy | Licensed Practical/Vocational Nurse | | 3 | 55-year-old with angina who has ST-segment changes on the heart monitor | Licensed Practical/Vocational Nurse | | 4 | 49-year-old three hours post-operative thyroidectomy | Registered Nurse | | 5 | 44-year-old requiring regular insulin titration for diabetic ketoacidosis | Registered Nurse | | 6 | 59-year-old requiring chronic wound care and the insertion of an indwelling bladder catheter | Registered Nurse | A. Room 1 B. Room 2 C. Room 3 D. Room 4 E. Room 5 F. Room 6
Answer (1)
This question involves assigning nursing staff appropriately based on the acuity and care needs of the patients. Let's review each room and determine if the assignment is appropriate:
A. Room 1 : A 67-year-old receiving antibiotics for bacterial cystitis is appropriately assigned to a Licensed Practical/Vocational Nurse (LPN/VN). This patient likely requires administration of routine medications like antibiotics and monitoring for side effects, which falls within the scope of practice for an LPN/VN.
B. Room 2 : A 22-year-old three days post-operative laparoscopic appendectomy can be cared for by a Licensed Practical/Vocational Nurse. This patient likely needs standard post-operative care, including pain management and wound care, which are tasks that an LPN/VN can handle.
C. Room 3 : A 55-year-old with angina who has ST-segment changes on the heart monitor should be cared for by a Registered Nurse. This is because ST-segment changes indicate potential cardiac issues that require careful monitoring, assessment, and possibly intervention, which are within an RN's scope of practice.
D. Room 4 : A 49-year-old three hours post-operative thyroidectomy requires care from a Registered Nurse. Post-operative patients, especially those recently out of surgery, require close monitoring for complications, which is appropriate for an RN.
E. Room 5 : A 44-year-old requiring regular insulin titration for diabetic ketoacidosis must be assigned to a Registered Nurse. The management of diabetic ketoacidosis involves frequent assessment and adjustment of insulin dosages, which is complex and requires an RN's expertise.
F. Room 6 : A 59-year-old requiring chronic wound care and the insertion of an indwelling bladder catheter is correctly assigned to a Registered Nurse. While wound care can sometimes be done by an LPN/VN, the insertion of an indwelling catheter and complex wound management is best done by an RN.
Based on this analysis, the assignments to focus on altering are Room 3, 5, and potentially 6, depending on the complexity and frequency of interventions required. The RN can better address the complexity of care needed in these situations.
