Question

Which task is best delegated to the licensed practical nurse? A. Beginning an infusion of platelets B. Inserting a nasogastric tube C. Flushing a central venous catheter D. Administering intravenous dexamethasone (Decadron)

Short answer

Answer: D. Administering intravenous dexamethasone (Decadron)

Step-by-step solution

Option A: Beginning an infusion of platelets

Infusing platelets is a task that often requires advanced skills and knowledge beyond the scope of practice for an LPN. This task may include monitoring for and managing adverse reactions and complications. It would be more appropriate for a registered nurse (RN) to perform this task.

Option B: Inserting a nasogastric tube

Inserting a nasogastric tube is a complex and invasive procedure that requires advanced skill and knowledge. Although some LPNs may have experience with this task, it is generally considered outside of their standard scope of practice. This task should also be performed by an RN.

Option C: Flushing a central venous catheter

Flushing a central venous catheter is a task that requires specialized knowledge and skills, which is beyond the scope of practice for an LPN. An RN or other professionals with advanced training should perform this task.

Option D: Administering intravenous dexamethasone (Decadron)

Administering intravenous medications, such as dexamethasone, is generally considered within the scope of practice for a licensed practical nurse. LPNs are trained to administer medications and monitor patients for side effects, making this task appropriate for delegation to an LPN. Based on the analysis of each option, the best task to delegate to a licensed practical nurse is:

Answer

D. Administering intravenous dexamethasone (Decadron)

Key concepts

Licensed Practical Nurse Responsibilities

Licensed Practical Nurses (LPNs) play a vital role in healthcare settings by providing basic nursing care. They work under the supervision of Registered Nurses (RNs) or doctors. Their main responsibilities include:

• Administering medications and monitoring for side effects.
• Collecting patient data, like vital signs.
• Assisting patients with daily activities, such as bathing and dressing.
• Documenting and reporting patient progress to the nursing team.
• Helping with basic wound care and dressing changes.

To ensure safe patient care, LPNs should only perform tasks within their training and expertise. When it comes to intravenous administration, such as with dexamethasone, LPNs are usually qualified if they have received specific training. However, more complex tasks often require additional credentials or the expertise of an RN.

Nursing Scope of Practice

The nursing scope of practice defines the procedures, actions, and processes that a nurse is permitted to undertake in accordance with their professional license. This ensures patient safety and care quality. Here’s a breakdown of what this involves:

• The scope is determined by state laws and regulations, which differ for each level of nursing.
• LPNs have a more limited scope compared to RNs, focusing mainly on routine and basic care.
• RNs have a broader scope that includes more complex and sensitive procedures.
• Nurses are required to adhere to standards defined by professional boards, such as the Board of Nursing.

While LPNs are skilled in many areas, certain tasks—like inserting nasogastric tubes or flushing central venous catheters—are outside their typical scope. RNs or specially trained healthcare professionals should address these procedures to enhance patient safety.

RN vs LPN Tasks

The responsibilities of Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) are similar yet distinct, each playing a crucial role within the healthcare team.

• RNs: These nurses have a wider range of responsibilities. They can perform complex procedures, administer medications, delegate tasks, and develop patient care plans. They also assess patient needs and evaluate outcomes.
• LPNs: While they assist RNs, LPNs handle more routine aspects of patient care that are within their competence. For example, administering medications like intravenous dexamethasone is typically within their scope when they are appropriately trained.

In a hierarchical setting, RNs are often responsible for supervising LPNs and ensuring that the tasks delegated to them are within an LPN’s scope of practice. RNs take charge of intensive monitoring and interventions, particularly those which require detailed clinical judgment and critical decision-making skills. Understanding these differentiated roles is crucial for optimal delegation and teamwork in healthcare environments.