A client who is reaching saturation with medication reports the onset of muscle soreness and fatigue, and the practical nurse (PN) notes that the client's skin is warm to the touch. Which action by the PN is a priority?

This question is related to the responsibilities and scope of practice of a practical nurse (PN) and a medication aide. A medication aide is a certified nursing assistant (CNA) who is responsible for administering daily medication to patients under the supervision of a licensed nurse, such as a PN or a registered nurse (RN). A PN is a licensed nurse who can provide routine care, observe patients’ health, assist doctors and RNs, and communicate instructions to patients regarding medication, home-based care, and preventative lifestyle changes.

Based on this information, the best action that the PN should take in this situation is c. Assign the remainder of medication administration to another PN who is performing treatments. This is because it would ensure that the medication administration is completed by another licensed nurse who has the knowledge, skills, and authority to do so. The PN who is performing treatments may have some spare time or be able to rearrange their schedule to accommodate the additional task. The PN should also communicate with the other PN and the medication aide about the situation and document the change of assignment in the patients’ records.

Option a is not a good choice, because it would be unfair and unethical to deny the medication aide’s request to leave if they are sick. The medication aide’s health and well-being are also important, and forcing them to stay and work could compromise their safety and the quality of care they provide to the patients.

Option b is not a good choice, because it would be outside the scope of practice of the UAPs to give medications to the patients. UAPs are not trained or certified to administer medications, and doing so could pose serious risks to the patients’ health and safety. The PN would also be liable for any errors or adverse outcomes that may result from the UAPs’ actions.

Option d is not a good choice, because it would not solve the problem of the medication administration being incomplete. Documenting why the medications were not given is important, but it is not enough to ensure that the patients receive their prescribed drugs and treatments. The PN still has the responsibility to find a way to complete the medication administration or delegate it to another qualified and available person.

A client with continuous urinary bladder irrigation via a 3-way catheter: This task requires specialized knowledge and skill to ensure proper management of the irrigation process, monitoring for complications, and adjusting the irrigation rate as needed. It falls within the scope of practice of the PN, who has the necessary training and expertise.
B. A client with urinary urgency and incontinence who is asking for a bedpan: This task can be safely and appropriately assigned to the UAP. Assisting the client with using a bedpan for voiding is a basic care task that does not require specialized nursing knowledge or skills.
C. A client with a full urinary bedside drainage unit after receiving a diuretic: Emptying a full urinary bedside drainage unit is a task that can be assigned to the UAP. It involves routine emptying and documentation of the drainage bag and does not require specialized nursing knowledge or skills.
D. A client with paraplegia who needs a urinary condom-catheter change: This task requires specialized knowledge and skill to perform a sterile procedure, ensure proper placement and securement of the condom catheter, and assess for any complications. It falls within the scope of practice of the PN, who has the necessary training and expertise.