1.11 Learning Activities
Flashcards
Click the Turn button to flip each card and see the answer, then use the arrow to move to the next card. Continue through the set and revisit cards as needed until you can recall the answers on your own.
Knowledge Check
Read each question carefully. Select the answer you think is correct. Then select Check to submit your answer. If your answer is incorrect, select Retry to try again. Use the arrow buttons to move between questions.
Check 1: Prioritization
Check 2: Delegation
Check 3: Leadership Conflict
NCLEX Next Generation-Style Question
Test your clinical judgment with this NCLEX Next Generation-style question.
Case Study
Leadership – Delegation and Prioritization
You are the RN caring for these six clients on the day shift. The following table is information you gathered from the morning handoff report. You are working with an LPN/VN and a CNA on your team. Both team members are competent and have worked on the unit for longer than three years.
| Client | Information from Morning Handoff Report |
|---|---|
| Room 102 – Female, age 77 | Diabetic, 1st day post-op ORIF left hip.
Vital signs every 2 hours. 0400: T 99.2°F, HR 88, RR 24, BP 144/88. Pedal pulses not palpable on left foot, and left foot is cooler, but capillary refill is present. Dressings are clean and dry. IV: D5.25 NS at 100 mL/hr. Clear liquid diet; poor intake due to nausea. Foley: Drained 125 mL of concentrated urine. Sliding scale insulin QID. Turn every 2 hours; record I&O. |
| Room 107 – Male, age 42 | Asthmatic bronchitis.
Vital signs every 4 hours. 0400: T 100.4°F, RR 24, pulse ox 92%. O2 at 2 L per nasal cannula. Coughing thick colorless mucus. Sputum specimen sent to lab for C&S. Nauseated but taking clear liquids. Respiratory therapy does nebulizer QID. IV antibiotics QID; IV needs to be changed this shift. Voiding in urinal. ABGs ordered for 0800. I&O. Minimal assist. |
| Room 103 – Male, age 65 | Gastric resection yesterday.
Vital signs hourly ranges: BP systolic 88–102, diastolic 44–62, HR 90–106, RR 22–24, afebrile. NG to low intermittent suction; 675 mL sanguineous drainage. IV: Lactated Ringer’s at 150 mL/hr. IV antibiotics every 6 hours. Unable to void; catheterized at 0430 with 250 mL. Coughs and deep breathes poorly. Oxygen at 2 L via nasal cannula. |
| Room 108 – Male, age 52 | Stable client admitted on night shift from recovery for post-op colon resection without a colostomy.
Post-op vitals every hour, all WNL. Record urine output every 2 hours. IV: D5/0.45 NS with 20 mEq KCl at 125 mL/hr. NG irrigations every 4 hours PRN. IV Pepcid every 12 hours, IV push. PCA morphine. Mark and reinforce dressing. Oxygen at 2 L via nasal cannula. Oximetry every 4 hours. IS every hour while awake. |
| Room 105 – Female, age 42 | Admitted at 0600.
Scheduled for breast biopsy today. Vital signs on admission: BP 128/82, HR 88, RR 22, Temp 98.5°F oral. NPO since midnight. Up ad lib. Pre-op checklist is completed. IV: Lactated Ringer’s at 100 mL/hr. Pre-op antibiotic and IM meds due at 0800. |
| Room 110 – Female, age 76 | Admitted yesterday afternoon with COPD with pneumonia.
O2 at 3 L via nasal cannula. Vital signs every 4 hours. 0400: Temp 99°F oral, RR 22 at rest, BP 106/54, pulse ox 93% on 3 L NC. IV antibiotics every 4 hours. Clear liquid diet. Up in chair for 20 minutes BID. Significant dyspnea on exertion. Requires complete assistance with ADLs. |
Case Study Questions
- What type of staffing model is being used in this scenario?
- Which tasks can be delegated to the LPN/VN?
- Which tasks cannot be delegated to the LPN/VN?
- Which tasks can be safely delegated to the CNA?
- Identify the highest priority client to see first. What are your top three priority tasks? Provide your rationale.
- Plan your shift: Prioritize the remaining five clients in the order you will see first and your top three priority tasks for each.
| Clients in the Prioritized Order You Will See Them and the Rationale for Doing So | Top Three Priority Tasks for Each Client |
|---|---|
Case study answers are located in the Answer Key at the end of the book.
