Tuesday, July 2, 2013

Types of Medical Occupations

    I have seen many questions regarding many types of medical occupations. I need to know abilities and responsibilities about all type of medical jobs because RN needs to delegate them to some medical works.

    I had been confused with Unlicensed Assistive Personnel (UAP), but I finally understood that they are people who don't have any medical license and work for medical field, such as Certified Nursing Assistant (CNA). They typically can assist with patient care for ADL, obtaining vital signs, in and out, transporting, ROM exercise, serving meal, bed making etc.

These are example questions related to UAP.

(1) Choice Multiple question – Select all answer choices that apply.

Which of the following clients should the nurse assign to unlicensed assistive personnel? Select all that apply.

a) A 3-month-old infant with dehydration who will be discharged tomorrow.
b) An 11-year-old child in sickle cell crisis admitted 3 hours ago.
c) A 5-year-old child with a fractured humerus going to surgery this morning.
d) A 17-year-old adolescent who underwent an appendectomy last night and now has stable vital signs.
e) A 16-year-old adolescent with mononucleosis and a temperature of 103.8º F (39.9º C).
f) A 10-month-old infant with bronchiolitis admitted last night.


Answer
• A 3-month-old infant with dehydration who will be discharged tomorrow.
• A 17-year-old adolescent who underwent an appendectomy last night and now has stable vital signs.

Explanation: Unlicensed assistive personnel are assigned to clients who have stable vital signs and are progressing as expected. The child who will be discharged tomorrow and the postoperative teenager with stable vital signs would be appropriate.


(2) The nurse assigns an unlicensed assistive personnel to care for a client who is one day postpartum. Which of the following would be appropriate to delegate to this person? Select all that apply.
a) Reinforcing good hygiene while assisting the client with washing the perineum.
b) Assisting the client with ambulation shortly after delivery.
c) Checking the location of the fundus prior to ambulating the client.
d) Assisting the mother to latch the infant onto the breast.
e) Changing the perineal pad and reporting the drainage.
f) Discussing postpartum depression with the client who is found crying.

• Changing the perineal pad and reporting the drainage.
• Reinforcing good hygiene while assisting the client with washing the perineum.
• Assisting the client with ambulation shortly after delivery.


Explanation: Delegating care to unlicensed assistive personnel requires that the nurse knows which tasks are within their capability. Changing the perineal pad and reporting drainage, reinforcing hygiene with perineal care, and assisting with ambulation are within the individual’s capacity. Unlicensed assistive personnel should never be asked to complete any assessments, such as checking fundal location or performing skilled procedures on a client. In addition, it would be above the scope for unlicensed assistive personnel to assist the mother with latching on and discussing postpartum depression with the client. State boards of nursing list the procedures and tasks that unlicensed assistive personnel can complete when directed.




How about what are different between Licensed practical nurses (LPN) and Licensed Vocational Nurse (LVN)? I figured out that they have the exact same tasks, and the only difference between LPN and LVN is the name. That is depending on which states they work for. In California, they are called LVN.

How about what are different between LVN and RN? LVN practices under the direction of a physician or RN. LVN can practice many medical care, but they are not allowed to assess, evaluate, educate patients, which must be done by RN. The LVN's scope varies by states. I couldn't figure out the official information for LVN about IV insertion from the site of Board of Vocational Nursing in CA. However, many people have been posting that LVN can not start IV in CA unless they have an IV certification.


What Do LPNs Do?


What Is the Difference Between RN & LVN?



Here is an example question related to LPN/LVN.

Choice Multiple question – Select all answer choices that apply.

Which procedures can the nurse working on a pediatric floor safely delegate to the licensed practical nurse (LPN). Select all that apply.
a) Calling the AM blood sugars to the physician.
b) Administering gastrostomy tube feedings.
c) Giving an IV push medication.
d) Refilling a baclofen pump.
e) Administering gastrostomy medications.

Answer
• Administering gastrostomy tube feedings.
• Administering gastrostomy medications.


Explanation: In general, LPNs may perform skills related to feeding and administering of enteral medications. Refilling a baclofen pump constitutes administering an intrathecal medication and is beyond the scope of practice for LPNs in most states. Some states and institutions allow LPNs to give IV push medicines, however special training is required. Communicating with the primary health care provider would require discussion of the client's assessments and evaluations which fall under the RN scope of practice.

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