Roles of Other Members of the Health Care Team

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Let’s briefly mention the roles of other possible members of the health care team. As an LPN/LVN, you may find yourself working with any or all of the following professionals:

• Nurse practitioners (NPs) are RNs with advanced education and training; in most states, NPs can diagnose illnesses and prescribe medications. If present in the health care setting, the NP would supervise the RN and the LPN/LVN, or just the RN who, in turn, would assign duties to the LPN/LVN.
• Nursing assistive personnel (NAPs) include both certified nursing assistants (CNAs), who are regulated by the state boards of nursing, and unlicensed assistive personnel (UAPs) including nursing assistants and home health aides. NAPs aid RNs and LPN/LVNs by performing routine duties, such as feeding and bathing stable clients. Obtaining specific supplies requested by the LPN/LVN or RN for the care of a client would also be part of the duties of an NAP.

Based on what you have learned about coordination of care and the duties of each member of the health care team, answer the next question.

1. The nursing unit contains an RN, an LPN/LVN, and an NAP. Which of the following client-care activities would be MOST appropriate for the LPN/LVN to perform?
   1. Obtain vital signs for a 6-year-old child who was admitted with several fractures.
   2. Monitor a 45-year-old woman, who had an ovarian tumor removed 2 days ago, for signs of infection.
   3. Teach a client recently diagnosed with diabetes mellitus to perform an insulin injection.
   4. Bathe a child who is recovering from an appendectomy and change his clothes.

1. A child admitted with several fractures is not in a stable condition and needs assessment, part of which is obtaining vital signs. An RN needs to provide the initial assessment. Eliminate this answer choice.
2. LPN/LVNs are trained to observe a client for changes in signs and symptoms, such as an increase in temperature or other signs of infection, and to report the changes to the supervising RN. Keep this answer choice for consideration.
3. Teaching a client with newly diagnosed diabetes mellitus to perform injection techniques is not within the scope of practice of an LPN/LVN. An RN performs this type of teaching. Eliminate this answer choice.
4. While an LPN/LVN could be asked to help in this situation, an NAP is more likely to be asked to perform this duty. An LPN/LVN is licensed, with specific education and training, so his or her services could probably be better used in another way. Eliminate this answer choice.

The correct answer is (2). Although the LPN/LVN could be asked to perform the duties listed in answer choice (4), that assignment would not be the most appropriate.

The following is another question to help you understand coordination of care.

1. Which of the following client-care assignments is BEST for an LPN/LVN?
   1. Help a client who is recovering from surgery with bathing, linen change, and ambulation to the bathroom.
   2. Perform a head-to-toe assessment, including breath sounds, for a client admitted yesterday with pneumonia.
   3. Assess a newly admitted client with a high fever and productive cough.
   4. Change the dressing for a stasis ulcer in a 65-year-old client with diabetes.

1. An NAP would normally be the person to help bathe and ambulate a client as well as change bed linen. Eliminate this answer choice.
2. LPN/LVNs routinely perform head-to-toe assessments, including breath sounds, for stable clients. As this client is recently admitted, the RN should do the assessment. Eliminate this answer choice.
3. RNs provide initial clinical assessment for newly admitted clients. Eliminate this answer choice.
4. LPN/LVNs are qualified to change dressings in stable clients. This is the best client-care assignment.

The correct answer is (4).