The charge nurse is making assignments for a 15-bed skilled nursing unit with the staff of one nurse, two practical nurses (PN), and two unlicensed assistive personnel (UAP). Which client should be assigned to the PN?
A.
The client who had bilateral above-knee amputations, now has a sacral decubitus skin flap, and is receiving vancomycin intravenously.
B.
The client who is in end-stage Alzheimer’s, who requires feeding, and is waiting for a long-term facility placement.
C.
The client who has pneumonia following a total knee replacement, and is receiving clarithromycin orally.
D.
The client who has right hemiplegia as the result of a cerebral vascular accident and receives continuous gastrostomy feedings per enteral pump.
The correct answer and Explanation is :
The correct answer is C: The client who has pneumonia following a total knee replacement and is receiving clarithromycin orally.
Here’s why this client is the most appropriate for assignment to a Practical Nurse (PN):
1. Scope of Practice for PN:
Practical Nurses (PNs) are trained to provide a range of care, including administering medications, monitoring vital signs, and performing routine procedures. They are well-equipped to manage clients with stable, but complex needs, such as those receiving oral antibiotics for pneumonia.
2. Client’s Condition:
The client with pneumonia following a total knee replacement is receiving oral antibiotics (clarithromycin), which indicates that their condition is stable enough to be managed with oral medications. This is a routine task that fits within the scope of a PN’s practice. They can monitor for side effects and effectiveness of the medication, which is a key part of managing pneumonia.
3. Other Clients’ Needs:
- A (Client with sacral decubitus skin flap and vancomycin): This client has a complex wound care situation and is on intravenous antibiotics. The management of intravenous medications and advanced wound care generally falls under the scope of a Registered Nurse (RN) due to the complexity and potential for complications.
- B (Client with end-stage Alzheimer’s): This client requires feeding and is waiting for long-term placement. While PNs can assist with feeding, clients in end-stage Alzheimer’s often have needs that require careful assessment and ongoing adjustments, which may be more appropriate for an RN.
- D (Client with right hemiplegia and continuous gastrostomy feedings): This client requires ongoing management of gastrostomy feedings and possibly other complex care needs related to their hemiplegia. Continuous feedings and the assessment of related complications might be better suited for an RN due to the potential for complications and the need for frequent reassessment.
Thus, the PN can effectively manage the care for the client with pneumonia, who has a stable condition and is receiving oral medication, making it the most appropriate assignment for their role.