Editing Management of Care – LPN Flashcards (section)

== Reporting and the Chain of Command ==

;What are the components of SBAR
:Situation, background, assessment, and recommendation. State clearly what is being asked for, not just what was observed.

;Trace the nursing chain of command from the LPN upward
:LPN to registered nurse to charge nurse to nurse manager to house supervisor or director to chief nursing officer, with risk management and the ethics committee as parallel resources.

;What does the LPN do when a reported concern is not acted on
:Escalate promptly to the next level of the chain of command, one level at a time, and document each step. Reporting once does not discharge the duty to the client.

;Name six changes that must be reported to the registered nurse immediately
:A new or worsening change in level of consciousness, new or worsening respiratory difficulty, a significant change in vital signs, new or changed chest pain, urine output under about 30 mL per hour, and any finding that is unexpected for that client's diagnosis.

;What is the rule about carrying out an order the LPN believes is unsafe
:Do not carry it out. Clarify with the registered nurse and the prescriber, and escalate if unresolved. A nurse who follows an order known or suspected to be wrong shares liability for the harm.