Case Study – Assigning, Delegating, Supervising, and Prioritizing Care

Assigning, Delegating, Supervising, and Prioritizing Care

Patients Assigned to the LPN

The LPN can be assigned to care for:

• Client 1: 50-year-old male with post-heart attack and stent placement with stable vital signs
• Client 5: 74-year-old female with new onset dementia awaiting lab results
• Client 6: 52-year-old female with newly diagnosed type 2 diabetes preparing for discharge

These patients are relatively stable and require routine care within the LPN’s scope of practice.

Care Delegated to LPN and CNA

For the LPN:

• Routine vital sign monitoring for all assigned patients
• Medication administration for assigned patients (excluding IV medications)
• Basic wound care and dressing changes (non-complex)
• Patient education on diabetes management for Client 6
• Assistance with activities of daily living (ADLs) as needed

For the CNA:

• Assistance with ADLs for all patients (bathing, grooming, toileting)
• Routine vital sign monitoring
• Turning and repositioning patients as needed
• Ambulation assistance for mobile patients
• Recording intake and output

Interventions to Supervise for LPN and CNA

For the LPN:

• Medication administration, especially for new prescriptions
• Patient education sessions, particularly for the newly diagnosed diabetic patient
• Assessment of the post-heart attack patient’s cardiovascular status
• Evaluation of the dementia patient’s cognitive status and safety

For the CNA:

• Proper technique for turning and repositioning patients, especially for Client 2 with burns
• Accuracy of vital sign measurements and documentation
• Proper hygiene practices, particularly for Client 2 with burns
• Correct use of assistive devices for ambulation

Clients and Care Prioritized from Highest to Lowest

• Client 4: 18-year-old male with wheezing and labored respirations

• • Immediate assessment of respiratory status
  • Administration of prescribed respiratory treatments
  • Continuous monitoring of oxygen saturation and respiratory rate
  • Preparation for a potential escalation of care if the condition worsens

• Client 2: 46-year-old female with full-thickness burns to the leg

• • Pain assessment and management
  • Sterile dressing change
  • Monitoring for signs of infection or complications
  • Fluid balance assessment
• Client 3: 33-year-old male with post-operative broken femur
  • Pain assessment and management
  • Neurovascular checks of the affected limb
  • Assistance with mobilization as per post-operative protocol
  • Monitoring for signs of compartment syndrome
• Client 1: 50-year-old male post-heart attack and stent placement
  • Cardiovascular assessment
  • Monitoring for post-procedure complications (Mayo Clinic, 2021)
  • Medication administration and education
  • Cardiac rehabilitation education
• Client 5: 74-year-old female with new onset dementia
  • Safety assessment and implementation of fall prevention measures (Mayo Clinic, 2019)
  • Cognitive assessment
  • Monitoring and interpreting lab results when available
  • Family education on dementia care
• Client 6: 52-year-old female with newly diagnosed type 2 diabetes
  • Diabetes education, including blood glucose monitoring and insulin administration (Romero-Castillo et al., 2022)
  • Discharge planning and coordination
  • Arrangement of follow-up appointments and home health services if needed

This prioritization is based on the acuity of the patient’s condition. respiratory distress is attended to first because the patient’s situation can go downhill very fast, followed by the burn and post-operative patients, who are at increased risk for complications. The other patients have stable conditions to lesser or greater degrees, which then places them at lower priority relative to these others.

The RN should openly communicate with the LPN and the CNA throughout the shift, reassessing patient conditions regularly to refocus care priorities as needed. This type of approach will ensure that all patients receive proper care while the effective use of staff resources and skills available is maximized in the most efficient manner.

References

Mayo Clinic. (2019). Dementia – Diagnosis and Treatment – Mayo Clinic. Mayoclinic.org; Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/dementia/diagnosis-treatment/drc-20352019

Mayo Clinic. (2021, October 8). Coronary angioplasty and stents – Mayo Clinic. Mayoclinic.org. https://www.mayoclinic.org/tests-procedures/coronary-angioplasty/about/pac-20384761

Romero-Castillo, R., Pabón-Carrasco, M., Jiménez-Picón, N., & Ponce-Blandón, J. A. (2022). Effects of a Diabetes Self-Management Education Program on Glucose Levels and Self-Care in Type 1 Diabetes: A Pilot Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 19(23), 16364. https://doi.org/10.3390/ijerph192316364

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Competency
Integrate leadership and management principles and attributes in nursing practice

Scenario
You are assigned to six patients on the medical-surgical unit, working with an LPN/LVN and sharing a CNA with another RN. You are receiving a report for your patients and need to identify what activities you will be assigning, delegating, supervising, and prioritizing for the shift.

Instructions

Module 02
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 type 2 diabetes and is getting discharged

1. Describe the patients you will be assigning to the LPN
2. Describe the care that you will be delegating to the LPN and CNA
3. List the interventions that you would want to supervise for the LPN and CNA
4. List the clients and care from the highest to lowest priority
5. Provides stated ideas with professional
language and attribution for credible sources with correct APA citation, spelling, and grammar.