Question

Multiple-choice question: Which scenario is within the nurse's scope of practice? A. Nurse A is caring for a patient who is out of surgery and no longer needs his epidural catheter. She removes it and makes sure the tip is intact. B. Nurse \(B\) is caring for a client who is out of surgery and no longer needs his epidural catheter. She calls the certified nursing assistant(CNA) to remove it. C. Nurse \(\mathrm{C}\) is caring for a patient who is out of surgery and no longer needs his epidural catheter. She calls the nurse anesthetist to remove it. D. Nurse D is caring for a patient who is out of surgery and no longer needs his epidural catheter. She transfers him to the medical-surgical unit with the catheter in place.

Short answer

The scenario in which Nurse \(A\) removes the epidural catheter herself after the patient is out of surgery and checks the tip is intact is within the nurse's scope of practice. Hence, the correct answer is option A.

Step-by-step solution

Understanding the scenario

Consider each scenario one by one. Analyze the role that Nurse A, Nurse B, Nurse C, and Nurse D are playing in their respective situations.

Analyzing Nurse A's action

Nurse A is removing the epidural catheter herself and making sure the tip is intact. This is a procedure that can be performed by a nurse.

Analyzing Nurse B's action

Nurse B is calling a Certified Nursing Assistant (CNA) to remove the catheter. However, this exceeds the CNA's scope of practice as they are not allowed to perform therapies or procedures.

Analyzing Nurse C's action

Nurse C is calling the nurse anesthetist to remove the catheter. This action is technically not incorrect, as the nurse anesthetist could remove it, but it's unnecessary because removing an epidural catheter is within the scope of practice of the nurse. Therefore, it may not be considered as efficient nursing.

Analyzing Nurse D's action

Nurse D is transferring the patient to another unit with the catheter still in place. This might be inappropriate depending on the hospital's protocol. Hence, this is not necessarily within the standard nursing scope of practice.

Key concepts

NCLEX-RN Exam Preparation

Preparing for the NCLEX-RN exam is a crucial step in becoming a licensed registered nurse. It's designed to assess the knowledge, skills, and abilities necessary for safe and effective entry-level nursing practice. Successful preparation often involves a combination of studying content areas, such as fundamentals of nursing care, pharmacology, and physiology, along with mastering test-taking strategies.

Effective study plans can include taking practice exams, joining study groups, and utilizing review courses. Many aspiring nurses find it helpful to focus on areas where they are less confident and practice with questions that mimic the style of the NCLEX.

Practice Through Application

Students can improve their readiness by applying their theoretical knowledge to scenarios similar to those found on the exam, reinforcing their understanding of nursing responsibilities and healthcare practices.

Nurse Responsibilities

Nurses play a critical role in the healthcare team, and understanding their responsibilities is essential for patient safety and quality of care. Their duties range from direct patient care to coordination of services and even involvement in healthcare policy.

Key responsibilities include performing patient assessments, administering medications, monitoring patient progress, educating patients and their families, and managing medical records. Additionally, they are often responsible for initiating life-saving procedures and providing emotional support to patients.

Nurses' Judgment and Autonomy

Nurses are expected to use their professional judgment to make decisions in the patient's best interests, while also working within the bounds of their legal scope of practice.

Epidural Catheter Removal

Epidural catheter removal is a skilled procedure that falls within the scope of practice for registered nurses, provided they have received appropriate training and competency validation.

The process requires careful assessment for complications and a meticulous technique to ensure the entire catheter is removed intact. It is imperative for the nurse to inspect the catheter tip and length upon removal, checking for signs of breakage or any abnormalities.

Importance of Protocol

Adherence to hospital protocols and aseptic technique during removal is paramount to prevent infection and ensure patient safety. This procedural knowledge reinforces the nurse's role in providing comprehensive patient care.

Healthcare Professional Roles

Each healthcare professional, from nurses to nursing assistants, plays a specific part in the patient care continuum. Understanding these roles is important for effective collaboration and ensuring the delivery of high-quality care.

Nurses often serve as the primary point of contact for patients, monitoring their condition and coordinating treatment plans. Certified nursing assistants, under the supervision of nurses, can assist with basic care tasks but are not qualified to perform procedures like epidural catheter removal.

Interdisciplinary Communication

Other specialists, such as nurse anesthetists, have advanced training in areas like anesthesia and pain management, but their skills may be underutilized if tasked with responsibilities that fall within the nurse's scope of practice. Effective communication and understanding of professional boundaries are key to an efficient healthcare team.