The charge nurse on a medical unit makes assignments for the nursing team composed of a registered nurse (RN), 2 licensed practical nurses (LPNs), and a student nurse (SN). Which assignment is the most appropriate?

Question

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A client experiencing changes in mental status severe enough to require transfer to the intensive care unit (ICU) is considered critically ill and is the most appropriate assignment for the RN. This client is unstable and requires the RN's advanced skills to perform ongoing neurological assessments (eg, respiratory pattern, level of consciousness, mental status, motor and sensory activity) and vital sign checks, to document findings, and to report the client's condition to the ICU nurse until the transfer can be completed. (Option A) This client is unstable and requires continuous assessment in a complex situation. Some states allow only RNs to administer blood transfusions. This assignment is not appropriate for an LPN. (Option B) Accurate assessment of pain and bowel sounds (eg, presence, absence, pitch) is critical in a newly admitted client with a bowel obstruction and should be performed by the experienced RN; this assignment is not appropriate for an LPN. (Option D) This client is at increased risk for aspiration; much of the RN's time will be spent observing and supervising the administration of oral and IV medications. This assignment is not appropriate for an SN. Educational objective: The more experienced RN is assigned to the client with more complex needs that require a more advanced level of nursing skill and judgment. LPNs can perform noninvasive interventions and certain invasive tasks for more stable clients.

The Charge Nurse on a Medical Unit Makes Assignments for the Nursing