A charge nurse has assigned a group of clients to a licensed practical nurse (LPN). The charge nurse receives reports from her assigned clients about the LPN's lack of care. Which of the following actions should the charge nurse take?
Discuss the LPN's behavior with other nurses on the unit.
Review the LPN's personnel file.
Talk with the clients who have reported the LPN's lack of care.
Reassign some of the LPN's client care to assistive personnel.
The Correct Answer is B
Rationale:
A. Discussing the LPN's behavior with other nurses could potentially lead to gossip and does not address the core issue.
B. Reviewing the LPN's personnel file provides insight into the LPN's past performance and any previous issues, which can help in understanding the current situation and deciding on the next steps.
C. Talking with the clients is important to understand their concerns, but it does not directly address the LPN's behavior and effectiveness.
D. Reassigning client care to assistive personnel does not address the root cause of the problem and may not be an appropriate or effective solution without further investigation.
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Correct Answer is B
Explanation
Rationale:
A. A client who has Guillain-Barre syndrome requires close monitoring and specialized care due to progressive weakness and potential respiratory issues. This client's care may involve more complex needs that are beyond the AP's scope.
B. A client who has a lumbosacral spinal tumor is likely to have fewer immediate needs related to eating assistance, making this task appropriate to delegate to the AP. The client’s primary concern may be mobility or pain management, but meal assistance is a routine task.
C. A client who has systemic sclerosis may have issues with gastrointestinal motility and swallowing, requiring more careful feeding assistance and monitoring, which should be performed by the nurse.
D. A client who has amyotrophic lateral sclerosis (ALS) requires specialized care for swallowing difficulties and respiratory issues, making it inappropriate to delegate meal assistance to the AP.
Correct Answer is ["A","C","E"]
Explanation
Rationale:
A. Applying an ambulation alarm can help alert staff if the client tries to move independently, thus reducing the risk of falls.
B. Restraints should only be used as a last resort and require a physician’s order. They should not be used routinely for fall prevention.
C. Instructing the client in the use of the call light empowers them to request assistance, which can help prevent falls.
D. Raising all side rails can be considered a restraint and may increase the risk of falls or injury. It is not a recommended practice for fall prevention.
E. Checking on the client hourly ensures ongoing monitoring and timely intervention if needed, which is effective in preventing falls.