Reference no: EM133988687
Assignment:
A 58-year old client is brought into the emergency room (ER) because of a high fever and decreasing level of consciousness. The client's son states that when he woke up this morning he found his mom lying on the couch. When he tried to ask her a question, he found her to be unresponsive. The son said his mom opened her eyes briefly when he shook her, but she had a "strange, staring gaze" and then immediately closed her eyes again.
The client's medical history includes hypertension and recent bariatric surgery. The registered nurse looks at the client's abdominal incision and observes that the incision is red, swollen, and draining purulent drainage. There is also a foul odor noted. Vital signs are as follows: Blood pressure 102/49 mm Hg; heart rate 104 beats/minute; O2 saturation 82%; respiratory rate 28 breaths/minute and temperature 102.8 F ( 39.3C).
Health Care Provider Orders:
1. Vital signs q 15 minutes
2. Assessment of orientation and alertness
3. Insert indwelling urinary catheter and send a urine sample for culture and sensitivity (C&S)
4. Oxygen via face mask at 6 L/min-maintain oxygen saturation at 90% or higher
5. Insert an intravenous (IV) line of Lactated Ringers (LR) to run at 125 mL/hour via pump
6. Complete blood count (CBC) and electrolytes
7. Gentamycin 80 mg IVPB every 8 hours
Available staffing in the ER includes a Registered Nurse (RN), a newly licensed Practical Nurse (LPN), and an experienced assistive personnel (AP).
Questions:
- The nurse asks the son if his mother has a living will. The son asks, "What is a living will?" What information should the nurse provide?
- The LPN is observing the AP move the client up in bed using a draw sheet. The AP has her legs straight and together. How should the LPN instruct the AP as to the proper way of moving a client up in bed?
- Based on the information provided in the case study, what is priority based on the initial reported client findings?
- What tasks can an LPN delegate to an AP? In this case study, what tasks can the LPN delegate to the AP?
- What are the five rights of delegation? Give an example of each.
- The AP tells the LPN that she did not insert the urinary catheter correctly and she should go back to school. How should the LPN handle the situation? What conflict resolution strategy would work best in this situation?