Module 2: Assigning, Delegating, & Prioritizing Care lOMoAR cPSD|3013804 LEADERSHIP AND PROFESSIONAL IDENTITY NUR 2832 MODULE TWO – ASSIGNING, DELEGATING, & PRIORITIZING CARE PROFESSOR: 1 lOMoAR cPSD|3013804 Module 2: Assigning, Delegating, & Prioritizing Care Scenario You are assigned to six patients on the medical surgical unit working with an LPN/LVN and share a CNA with another RN. You are receiving report for your patients and need to identify what activities you will be assigning, delegating, supervising, and prioritizing for the shift. Instructions Client number 1: 50-year-old male who had a heart attack and stent placed with normal vital signs Client number 2: 46-year-old female with full-thickness burns to the leg who needs to have dressings changed Client number 3: 33-year-old male firefighter who has fallen and broken his right femur after surgery with pain in his leg Client number 4: 18-year-old male with wheezing and labored respirations unrelieved by an inhaler Client number 5: 74-year-old female with new-onset dementia awaiting lab results Client number 6: 52-year-old female who has been recently diagnosed with diabetes type 2 and is getting discharged 1). Describe the patients you will be assigning to the LPN I would assign client #2 - the 46-year-old female with full-thickness burns and client #3 - with the broken RIGHT femur to the LPN. These two clients are the most medically stable, and their care needs do not immediately require the presence of an RN. For a patient whose condition is stable and predictable, and rapid change is not anticipated, the supervisor may provide supervision of the LPN without being physically present (KBN, 2018). Client #2 requires dressing changes; the task is not difficult, and the outcome is predictable. Client #3 is reporting pain, most likely related to his surgical procedure. Decisions to delegate nursing tasks, functions, and activities are based on the needs of the clients, the stability of the clients' conditions, complexity of the task, predictability of the outcome, and the available resources to meet those needs and the judgment of the nurse (Weberg, 2018). 2 lOMoAR cPSD|3013804 Module 2: Assigning, Delegating, & Prioritizing Care 2). Describe the care that you will be delegating to the LPN and CNA I would have the CNA provide care to the 74 y/o female with new-onset dementia (client #5); toileting, assist with bathing, eating, hygiene, etc. Common tasks delegated to nurse assistants include most activities of daily living, bathing, feeding, ambulating, taking vital signs, and performing skincare (Weberg, 2018). In addition, I would expect the CNA to continue answering call lights as long as the situation is safe, and allows them to do so. Cares that could be delegated to the LPN include measurements of physiologic function, observation of a client's subjective and objective signs and symptoms, determining a client's need for nursing intervention, and to perform assessments under the supervision of an RN (Weberg, 2018). I would ensure that the LPN can competently perform the dressing change to the burns as long as there are no s/sx of infection or necrosis to the affected areas. Of course, if the LPN is unsure of anything, they would notify either myself or the other on-shift RN. In addition, I would also ensure the stability of both of the clients’ VS, alertness and orientation, respiratory status, and pain on their patients and notify myself or the other on shift RN of any changes. 3). List the interventions that you would want to supervise for the LPN and CNA LPN - Instruct LPN to look for s/sx of compartment syndrome including pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia. Should these occur, notify the RN immediately. - Look for internal or external rotation of the RLE, ensure the wedge pillow is in place, and appropriate positioning.