Coordination of Care Questions

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Here are a few more questions to test your understanding of coordination of care.

1. Which of the following client-care activities should be assigned to an LPN/LVN?
   1. Auscultate breath sounds and collect sputum sample from a client with a history of respiratory problems.
   2. Assess a client just returned from surgery to correct a spinal deformity.
   3. Provide emergency care to a client who suffered cardiac arrhythmia during exercise.
   4. Care for an unconscious client who is bleeding profusely from a stab wound.

1. An LPN/LVN can auscultate breath sounds, report the findings to the RN, and collect a sputum sample for analysis. Keep this answer choice for consideration.
2. Immediate postoperative assessment is the responsibility of the RN, especially in such a serious case as spinal surgery. The RN may subsequently ask the LPN/LVN to monitor the client, requesting that he be alert for specific signs/symptoms. Eliminate this answer choice.
3. LPN/LVNs are not usually employed in emergency departments, but if they are, they help the RN (or primary health care provider), following specific instructions. Eliminate this answer choice.
4. An unconscious client who is bleeding profusely from a stab wound is in unstable condition and has an unpredictable outcome. An LPN/LVN does not routinely provide care for such an unstable client. Eliminate this answer choice.

The correct answer is (1).

1. Which of the following client-care activities should be assigned to an LPN/LVN?
   1. Assess a new admission who is reporting of severe abdominal pain.
   2. Review the education on birthing methods provided to a pregnant client.
   3. Provide bedside care for an infant client with a fever and obvious discomfort.
   4. Change the dressing of a client who has undergone a partial mastectomy.

1. Obtaining a complete assessment on a newly admitted client is the responsibility of an RN. Eliminate this answer choice.
2. While an LPN/LVN may provide reinforce teaching to a pregnant client on birthing methods, only an RN can evaluate the effectiveness of the teaching. Eliminate this answer choice.
3. Fever in an infant is a serious concern that requires careful assessment and frequent monitoring, tasks that should be performed by an RN. Eliminate this answer choice.
4. LPN/LVNs are qualified to look for changes in the appearance of a wound and to change dressings as part of their overall monitoring of a stable client recovering from surgery. Keep this answer choice for consideration.

The correct answer is (4).

As stated earlier, health care in the United States, with its ever more sophisticated tests, techniques, and treatments, in combination with budget constraints and frequent understaffing, requires the coordination of care among licensed and unlicensed members of the health care team. Each member of the team must be called upon to contribute specific knowledge and skills so that an integrated personalized plan of care for each client is implemented. It is very important to utilize the specific education, training, and skills of an LPN/LVN, who provides bedside care for stable clients under the supervision of an RN. Doing so frees the RN to perform assessment, nursing diagnosis, development and implementation of a plan of care, and evaluation. At the same time, the assignment of time-consuming routine tasks, such as bathing and feeding stable clients, to an NAP allows the licensed members of the team to maximize the use of their skills.

An understanding of the coordination of care is essential for an LPN/LVN and for other members of the health care team. The efficient use of each member’s specific knowledge and skills allows the pursuit of a common goal—the best care possible for the client.