The medical-surgical unit works with an LPN/LVN and shares a CNA with another RN.

Full Answer Section

• CNA:
  • Vital sign monitoring: Check for accuracy and consistency.
  • Specimen collection: Ensure proper labeling and handling.
  • Reporting changes in condition: Verify that the CNA is communicating any significant changes to the RN.

Priority Care:

1. Client 4: The patient with wheezing and labored respirations needs immediate attention to prevent respiratory failure.
2. Client 3: The patient with a broken femur requires pain management and monitoring for complications.
3. Client 1: The patient who recently had a heart attack needs close monitoring for signs of instability.
4. Client 2: The patient with burns requires frequent dressing changes and pain management.
5. Client 5: The patient with new-onset dementia requires close monitoring and evaluation of lab results.
6. Client 6: While discharge planning is important, it can be prioritized lower than the other patients.

Note: This is a general plan and may need to be adjusted based on the specific needs of each patient and the availability of resources.

Sample Solution

Patient Assignment, Delegation, and Supervision

Patient Assignment to LPN:

Given the LPN's education and scope of practice, I would assign the following patients to them:

1. Client 2: The patient with full-thickness burns requires frequent dressing changes, which can be delegated to the LPN.
2. Client 5: The patient with new-onset dementia requires close monitoring, but once the lab results are in, the LPN can assist with routine care.
3. Client 6: The patient being discharged can benefit from the LPN's knowledge and skills in patient education and discharge planning.

Delegation to LPN and CNA:

• LPN:
  • Assist with dressing changes for Client 2.
  • Monitor vital signs for Clients 1, 3, 4, and 5.
  • Administer medications as ordered.
  • Provide patient education for Client 6.
  • Assist with discharge planning for Client 6.
• CNA:
  • Assist with personal hygiene and activities of daily living for all patients.
  • Obtain vital signs as needed.
  • Collect specimens as ordered.
  • Report any changes in patient condition to the RN.

Interventions to Supervise:

• LPN:
  • Dressing changes for Client 2: Ensure proper technique to prevent infection and promote healing.
  • Medication administration: Verify correct medication, dosage, route, and time.
  • Patient education: Observe the LPN's ability to effectively communicate information to the patient and family.