A charge nurse in a long-term care unit is planning care for a group of clients. Which of the following care tasks should the nurse plan to delegate to an assistive personnel?

A. Methadone: Methadone is a long-acting opioid agonist commonly used in the management of neonatal abstinence syndrome resulting from in utero opioid exposure. It stabilizes withdrawal symptoms by binding to mu-opioid receptors and preventing the abrupt cessation effects that occur after birth. Its longer half-life allows for controlled tapering, reducing autonomic instability, irritability, tremors, and feeding difficulties.

B. Meperidine: Meperidine is a short-acting opioid analgesic primarily used for acute pain management and is not recommended for withdrawal treatment. Its metabolite, normeperidine, can accumulate and cause neurotoxicity, including seizures, especially in neonates with immature hepatic and renal function.

C. Hydromorphone: Hydromorphone is a potent opioid analgesic used for severe pain but lacks the pharmacokinetic profile required for structured withdrawal therapy. Its shorter duration of action increases the risk of fluctuating serum levels, which may worsen withdrawal instability. It is not part of standard neonatal abstinence syndrome treatment protocols.

D. Fentanyl: Fentanyl is a highly potent, short-acting synthetic opioid typically used for anesthesia and severe acute pain. Due to its rapid onset and short duration, it does not provide the steady opioid receptor stimulation required to gradually taper withdrawal symptoms in neonates. Its potency also increases the risk of respiratory depression in this population.

A. Coordinating client care: Coordination of care involves synthesizing assessments, planning interventions, and collaborating with multiple disciplines, which requires independent clinical judgment. This responsibility falls within the registered nurse’s scope of practice, not the LPN’s.

B. Providing direct client care: LPNs are trained to provide hands-on care, including administering medications (excluding certain IV medications), monitoring vital signs, assisting with activities of daily living, and implementing established care plans. Direct client care is a primary LPN responsibility and aligns with their scope of practice under RN supervision.

C. Assessing a client's health status: Comprehensive assessment, interpretation of findings, and determining nursing diagnoses require independent critical thinking and clinical decision-making. These tasks are within the RN scope and exceed the LPN’s role, which focuses on collecting data and reporting changes.

D. Providing a client with discharge instructions: Teaching clients about medications, follow-up care, or lifestyle modifications involves patient education and clinical judgment. LPNs may reinforce previously taught instructions but do not independently initiate discharge teaching, which is an RN responsibility.