As charge nurse, you would assign the nursing care of which patient to an LPN/ LVN, working under the supervision of an RN?

• A. 48-year-old with cystitis who is taking oral antibiotics
• B. 64-year-old with kidney stones who has a new order for lithotripsy
• C. 72-year-old with urinary incontinence who needs bladder training
• D. 52-year-old with pyelonephritis who has severe acute flank pain

Answer: (A)

Under RN supervision, an LPN/LVN works best with stable, uncomplicated care that involves routine meds and monitoring. A patient with cystitis who is taking oral antibiotics fits this scenario perfectly: the infection is stable, the plan centers on administering the oral antibiotic and watching for response or any adverse effects, then reporting back to the RN with any changes.

The other situations require higher acuity or RN-directed assessment and planning. A new lithotripsy order involves a procedure with pre- and post-procedure needs, potential anesthesia considerations, and monitoring for complications—roles that typically fall to the RN. A patient needing bladder training for urinary incontinence requires ongoing assessment and potential adjustments to the plan based on response; while an LPN can support and carry out bladder-training steps, the RN should oversee evaluation and modification of the plan. A patient with pyelonephritis and severe acute flank pain is an unstable, acute condition needing rapid assessment and possible IV antibiotics and close monitoring, which also requires RN-level care.