Editing LPN Skills and Practice Limitations (section)

== Skills Commonly Within LPN Scope ==

=== Medication administration ===

* Oral, sublingual, and buccal medications.
* Topical, transdermal, ophthalmic, otic, nasal, rectal, and vaginal medications.
* Inhaled medications, including metered dose inhalers and nebulizer treatments.
* Subcutaneous injections, including insulin and most anticoagulants.
* Intramuscular injections, including immunizations where state law permits.
* Enteral medication administration through a nasogastric or gastrostomy tube where state rules permit.
* Application of the rights of medication administration, checking allergies, verifying dose calculations, and independent double checks of high alert drugs such as insulin per policy.
* Observation for therapeutic effect and adverse reactions, and prompt reporting of both.

Controlled substance handling, waste with a second licensed witness, and narcotic counts are ordinarily within LPN scope.

=== Urinary elimination ===

* Straight or intermittent urinary catheterization using sterile technique.
* Insertion, care, irrigation where ordered, and removal of an indwelling urinary catheter.
* Collection of sterile and clean catch urine specimens.
* Bladder scanning where the facility has trained the LPN on the device.
* Ostomy and urostomy appliance care and skin protection.

=== Wound and skin care ===

* Clean and sterile dressing changes for established wounds.
* Wound irrigation and packing per an established order and plan.
* Ongoing observation of wounds and documentation of size, drainage, odor, and periwound skin.
* Pressure injury prevention: repositioning, support surfaces, moisture management, and use of a validated risk scale as an ongoing screening tool.
* Application of prescribed topical treatments and negative pressure dressing maintenance where the facility trains and permits it.
* Suture and staple removal where state rules permit.

=== Respiratory and airway care ===

* Oxygen administration by nasal cannula and mask per order or protocol.
* Pulse oximetry and incentive spirometry coaching.
* Oropharyngeal, nasopharyngeal, and tracheal suctioning.
* Tracheostomy care, including inner cannula care and site care.
* Assisting the patient with a stable, established airway and reporting any change.

=== Gastrointestinal and nutrition ===

* Nasogastric tube insertion, verification per policy, and care where state rules permit.
* Administration of enteral feedings and flushes, and gastrostomy tube site care.
* Feeding assistance, aspiration precautions, and intake documentation.
* Enema administration and bowel program implementation.

=== Data collection and monitoring ===

* Vital signs, weights, intake and output, and pain rating using validated scales.
* Focused physical observation and comparison to established baselines.
* Capillary blood glucose monitoring.
* Application and monitoring of continuous pulse oximetry and, in many settings, application of cardiac monitoring leads and obtaining a twelve lead electrocardiogram where the facility trains the LPN. Interpretation of the tracing and clinical decision making on it are generally not LPN functions.
* Specimen collection: urine, stool, sputum, wound cultures, and capillary blood.
* Neurovascular checks, incision checks, and drain output measurement.

=== Other common skills ===

* Positioning, transfers, ambulation, range of motion, and use of assistive devices.
* Application of antiembolism stockings and sequential compression devices.
* Restraint application and monitoring per order and policy, with the RN and provider responsible for the assessment and the order.
* Preoperative and postoperative routine care within an established plan.
* '''Reinforcement''' of teaching the RN has already initiated, using approved materials.
* Documentation, handoff reporting, and participation in care conferences.
* Supervision of unlicensed assistive personnel where state law permits.
* Postmortem care.