Chapter 1
Leadership Case Study Answers
1. What type of staffing model is being used in this scenario?
There is no acuity score noted, so it is ratio-based. It is also considered ‘team’ nursing given that there is also a C.N.A and a LPN/LVN on the team with the RN
2. Which tasks can be delegated to the LPN/VN?
Room 102- insulin, IV fluids, Room 107 Oxygenation management, IV antibiotics, Room 103, IV antibiotics, cough and deep breathing and oxygenation management, Room 108 IV fluids, NG irrigation, oxygenation and oximetry , Room 105 Preop IV antibioticanditibiotic and IM medication Room 110 Oxygenation, IV antibiotics, up to chair 20 minutes
3. Which tasks cannot be delegated to the LPN/VN?
Room 102- Post op assessment and peripheral vascular assessment. Room 107 IV change and ABGs, respiratory assessment Room 103: GI assessment Room 108: IV push pepcid, PCA Morphine, assess surgical site and dressing Room 105: Surgical consent Room 110: Respiratory assessment
4. Which tasks can be safely delegated to the C.N.A.?
Collection of vital signs , I and O for rooms 102 and 107, Turn every two hours room 102, reminder to do IS every hour room 108
5. Identify the highest priority patient to see first. What are your top 3 priority tasks? Provide your rationale.
Room 103 is the priority patient. I would first assess the patient’s current vital signs, as his blood pressure has been low and his heart rate is high. I would then evaluate the NG drainage as sanguinous is concerning because there is a risk that the patient is bleeding internally. I would then contact the provider to consider increasing IV fluids to support blood pressures and evaluate the concern for bleeding.
6. Plan your shift: Prioritize the remaining five patients in the order you will see first and your top 3 priority tasks for each.
| Patients in the prioritized order you will see them and the rationale for doing so | Top 3 priority tasks for each patient |
|---|---|
| Room 102 – First day post op with a non-palpable pulse on the operative limb | Peripheral vascular assessment and pulse check with a Doppler.
Assess for swelling, tenderness, changes in skin color to check for deep vein thrombosis Complete a pain assessment in operative leg |
| Room 107 -ABGs ordered and respiratory rate 24 with pulse ox 95% | Complete a respiratory assessment including vital signs
Obtain ABGs Encourage patient to be up to chair |
| Room 110– Client is dyspneic with exertion | Complete respiratory assessment
Assess dyspnea and oxygenation status and ensure oxygen level is appropriate to patient IV antibiotics as ordered |
| Room 105-Surgery today-Stay on time | Review preop checklist and ensure consent is ready.
Assess client’s anxiety regarding procedure and educate client as needed Ensure preop antibiotic and IM meds are completed |
| Room 108–Stable postop | GI assessment and check surgical dressing
Assess placement and irrigate NG Administer IV pepcid and encourage IS use |
All of the answers to the interactive element are found within the element.
