A nurse assisting with the discharge plan of care for a group of children. For which of the following children should the nurse recommend a referral Speech therapy?

A. Serve meals with plastic utensils: Clients who have attempted suicide are at risk of self-harm. Using plastic utensils reduces the risk of injury from sharp objects and is an immediate safety intervention to prevent further attempts. This is a standard precaution in suicide precautions.

B. Assign another client to accompany the client to therapy sessions: Clients at risk for suicide should be supervised by staff, not other clients. Relying on peers does not ensure safety and may place both clients at risk, making this an inappropriate intervention.

C. Assign the client to a private room: While privacy can provide comfort, placing a high-risk client in a private room without adequate observation increases the risk of unnoticed self-harm. Clients at risk for suicide require close monitoring and a safe environment with staff visibility.

D. Check on the client every 4 hr: Suicide precautions require frequent observation, often continuous or at least every 15–30 minutes depending on risk level. Checking every 4 hours is insufficient and does not adequately ensure client safety.

A. Coordinating client care: Coordination of care involves synthesizing assessments, planning interventions, and collaborating with multiple disciplines, which requires independent clinical judgment. This responsibility falls within the registered nurse’s scope of practice, not the LPN’s.

B. Providing direct client care: LPNs are trained to provide hands-on care, including administering medications (excluding certain IV medications), monitoring vital signs, assisting with activities of daily living, and implementing established care plans. Direct client care is a primary LPN responsibility and aligns with their scope of practice under RN supervision.

C. Assessing a client's health status: Comprehensive assessment, interpretation of findings, and determining nursing diagnoses require independent critical thinking and clinical decision-making. These tasks are within the RN scope and exceed the LPN’s role, which focuses on collecting data and reporting changes.

D. Providing a client with discharge instructions: Teaching clients about medications, follow-up care, or lifestyle modifications involves patient education and clinical judgment. LPNs may reinforce previously taught instructions but do not independently initiate discharge teaching, which is an RN responsibility.