IV potassium chloride (KCl) 60 mEq is prescribed for a 49-year-old female patient with severe hypokalemia. Which action should the nurse take?

Choice A reason:

Instructing the client to hold a pillow to the abdominal incision when coughing is a task that involves patient education and reinforcement of postoperative care techniques. While LPNs/LVNs can provide basic patient education, this specific task requires ensuring that the patient understands the importance of splinting the incision to reduce pain and prevent complications such as wound dehiscence. This level of instruction is typically within the scope of practice for a registered nurse (RN), who has more extensive training in patient education and postoperative care. Therefore, this task is not the most appropriate for delegation to an LPN/LVN.

Choice B reason:

Obtaining bedside blood glucose is a task that is appropriate for delegation to an LPN/LVN. LPNs/LVNs are trained to perform routine tasks such as monitoring vital signs, including blood glucose levels, especially in patients with diabetes. This task involves using a glucometer to measure the patient’s blood sugar levels and recording the results. It does not require complex clinical judgment, making it suitable for an LPN/LVN. Regular monitoring of blood glucose is crucial for managing diabetes and preventing complications such as hyperglycemia or hypoglycemia.

Choice C reason:

Creating the plan of care is a complex task that involves comprehensive assessment, critical thinking, and clinical judgment. This task is typically within the scope of practice for an RN, who is trained to develop and implement individualized care plans based on a thorough assessment of the patient’s needs, medical history, and current condition. The RN collaborates with other healthcare team members to ensure that the care plan addresses all aspects of the patient’s recovery and health maintenance. LPNs/LVNs can contribute to the care plan by providing input and performing delegated tasks, but they do not have the authority to create the plan of care independently.

Choice D reason:

Documenting postoperative teaching involves recording the education provided to the patient about their postoperative care, including instructions on medication, activity restrictions, wound care, and signs of complications to watch for. This task requires ensuring that the patient understands the information and can follow the instructions correctly. While LPNs/LVNs can reinforce teaching and provide basic education, the initial comprehensive teaching and documentation are typically the responsibility of an RN. The RN ensures that the teaching is thorough and that the patient has the necessary knowledge to manage their care at home.

Choice A: Show the caregiver how to check the patient’s temperature and blood pressure
Showing the caregiver how to check the patient’s temperature and blood pressure involves direct patient education and demonstration, which requires the clinical judgment and expertise of a licensed nurse. This task ensures that the caregiver understands the correct techniques and can accurately monitor the patient’s vital signs. Delegating this task to assistive personnel (AP) is not appropriate because it requires a higher level of skill and knowledge to teach and verify understanding.
Choice B: Give the patient a pamphlet that reinforces teaching done by the nurse
Giving the patient a pamphlet that reinforces teaching done by the nurse is a task that can be delegated to assistive personnel (AP). This action does not require clinical judgment or advanced skills. The pamphlet serves as a supplementary resource to the verbal and hands-on education provided by the nurse. It is a straightforward task that AP can perform, ensuring that the patient has access to written information that reinforces the nurse’s teaching.
Choice C: Evaluate whether the patient and caregiver understand the teaching
Evaluating whether the patient and caregiver understand the teaching is a critical component of the discharge process that requires the clinical judgment of a licensed nurse. This task involves assessing the patient’s and caregiver’s comprehension, identifying any gaps in understanding, and providing additional education as needed. It is not appropriate to delegate this responsibility to assistive personnel (AP) because it requires professional assessment skills.
Choice D: Plan topics for the discharge teaching session with the patient and caregiver
Planning topics for the discharge teaching session with the patient and caregiver involves developing a comprehensive and individualized teaching plan based on the patient’s specific needs and condition. This task requires the expertise and clinical judgment of a licensed nurse to ensure that all relevant topics are covered and that the teaching plan is tailored to the patient’s situation. Delegating this task to assistive personnel (AP) is not appropriate because it requires advanced planning and professional knowledge.