Chapter 1 of 614% of exam

Coordinated Care

Coordinated Care covers how the LPN/LVN works within the health care team to plan, deliver, and communicate safe client care. It includes scope of practice, delegation and supervision, legal and ethical responsibilities, confidentiality, prioritization, and clear documentation. The LPN/LVN gathers data, reinforces teaching, and reports findings to the registered nurse (RN), who retains responsibility for assessment, care planning, and evaluation.

Scope of Practice and Delegation

The LPN/LVN practices under the direction of an RN or provider and performs tasks that follow established plans of care. Understanding what may be delegated to unlicensed assistive personnel (UAP) and what must be retained by licensed staff protects clients from harm.

Know the LPN/LVN scope
LPN/LVNs collect data, administer many medications, and provide basic care; they do not perform the initial assessment, create the care plan, or give initial teaching.
Delegate only stable, routine tasks to UAP
UAP may perform hygiene, feeding of clients without swallowing risk, ambulation, and recording of intake and output for stable clients.
Never delegate the nursing process
Assessment, planning, evaluation, and clinical judgment cannot be delegated to UAP.
Use the five rights of delegation
Delegate the right task, under the right circumstances, to the right person, with the right direction and the right supervision.

Legal and Ethical Responsibilities

The LPN/LVN is accountable for practicing within the law and following ethical principles such as autonomy, beneficence, and nonmaleficence. Recognizing legal duties helps prevent negligence and protects both clients and the nurse.

Honor client autonomy
Competent adults may refuse treatment; document the refusal and notify the RN or provider.
Report unsafe or dishonest practice
Falsified documentation, impaired coworkers, and unsafe conditions must be reported through the chain of command.
Act as a mandatory reporter
Suspected abuse or neglect of children, elders, or vulnerable adults must be reported to authorities.
Support informed consent
The provider explains the procedure and obtains consent; the nurse witnesses the signature and notifies the provider of client questions.

Confidentiality and Information Sharing

Protected health information may be shared only with those involved in the client's care or as required by law. Maintaining confidentiality builds trust and meets legal requirements under privacy laws.

Share on a need-to-know basis
Only members of the care team who need information to provide care may access it.
Avoid casual disclosure
Do not discuss clients in public areas or with people not involved in care.
Follow authorized exceptions
Mandatory reporting and communication with the treating team are permitted disclosures.
Protect records and screens
Log off computers and secure printed records to prevent unauthorized access.

Prioritization and Care Coordination

The LPN/LVN helps set priorities among multiple clients and coordinates care with the interdisciplinary team. Systematic prioritization ensures that the most urgent needs are met first.

Use the ABCs
Address airway, breathing, and circulation problems before other needs.
Apply Maslow's hierarchy
Meet physiologic and safety needs before comfort, teaching, or self-esteem needs.
Identify actual over potential problems
Real, life-threatening problems generally take priority over potential risks.
Communicate changes promptly
Report new or worsening findings to the RN so the plan of care can be adjusted.

Communication and Documentation

Accurate, timely communication and documentation support continuity of care and legal accountability. Standardized tools reduce errors during hand-off and reporting.

Use SBAR for hand-off
Report the Situation, Background, Assessment, and Recommendation to organize communication.
Document objectively
Record specific, factual, measurable data with the time of the observation.
Read back verbal orders
Write down and read back verbal or telephone orders and have them signed per policy.
Chart promptly and correct properly
Document care after it is provided and correct errors according to facility policy without obscuring the original entry.
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Last updated: July 2026

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