A patient who is receiving dobutamine (Dobutrex) for the treatment of acute decompensated heart failure (ADHF) has the following nursing interventions included in the plan of care
Which action will be most appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)?
a. Assess the IV insertion site for signs of extravasation.
b. Teach the patient the reasons for remaining on bed rest.
c. Monitor the patient's blood pressure and heart rate every hour.
d. Titrate the rate to keep the systolic blood pressure >90 mm Hg.
ANS: C
An experienced LPN/LVN would be able to monitor BP and heart rate and would know to report significant changes to the RN. Teaching patients, making adjustments to the drip rate for vasoactive medications, and monitoring for serious complications such as extravasation require RN level education and scope of practice.
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