In planning care for a patient with a stage III pressure ulcer, which action is appropriate to delegate to an LPN/LVN under supervision?

• A. Dressing change and wound cleaning
• B. Assess risk factors for ulcers
• C. Determining the most appropriate dressing for the wound
• D. Planning discharge education

Answer: (C)

Delegation in wound care centers on who plans versus who implements. For a stage III pressure ulcer, the nurse who oversees the plan remains responsible for the overall assessment and care strategy, while the LPN/LVN executes prescribed actions under supervision. Determining the most appropriate dressing for the wound fits as an implementation decision that can be delegated when there’s a standing protocol or clear orders guiding dressing options. The LPN/LVN can select and apply the approved dressing based on documented wound characteristics, with the RN supervising and ready to reassess and adjust as needed. This keeps care efficient and consistent with the plan, while maintaining patient safety and accountability with the RN.

Risk-factor assessment for ulcers is an assessment task that typically requires RN judgment and documentation of new risk factors. Planning discharge education involves patient teaching and discharge planning, which are RN responsibilities. Dressing changes and wound cleansing are direct care activities that can be performed by an LPN/LVN under supervision, but the decision-making step about which dressing to use is best delegated in this context.