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Licensed Practical Nurse-Certified (LPN-C) Description of LPN-C Practice
Intravenous therapy is a complex activity and, within nursing, is the responsibility of the registered nurse as prescribed by the licensed practitioner. A licensed practical nurse-certified may perform limited intravenous therapy interventions under the direction of a registered nurse or licensed practitioner. A licensed practical nurse-certified may be used to complement the registered nurse’s role or licensed practitioner role in the administration of intravenous therapy, but cannot be used as a substitute for the registered nurse or licensed practitioner. An LPN-C may only provide intravenous interventions when there is a licensed practitioner or registered nurse assessing the client at least once every 24 hours, or more frequently when a significant change in therapy or client condition has occurred.
When under the direct supervision of an RN or licensed practitioner, an LPN-C may perform these activities for an adult client:
- Infuse intravenous fluids and administer approved medications into a continuous flow central line. Infusing fluids and administering approved medications into an intermittent central line is not permitted.
- Administer an initial dose of an approved medication as described in
172 Nebraska Administrative Code (NAC) 102-003 Practice of Licensed Practical Nurses - Certified - Eligibility to Practice, by an approved method.
- Add Dextrose 10% as a meal replacement.
When under the direction of an RN or licensed practitioner, an LPN-C may perform these activities for an adult client:
- Perform venipuncture in the hand, forearm, antecubital fossa area, and/or the upper arm with a device three inches in length or less. For the initial venipuncture, the RN or licensed practitioner must have performed a face to face assessment of the current status of the client.
- Calculate rate of flow.
- Administer approved medications, as described in
172 NAC 102-003 Practice of Licensed Practical Nurses - Certified - Eligibility to Practice, by approved methods. If administering pain medications through a patient controlled administration pump, the cassette or syringe must have been commercially prepared, or prepared by a pharmacist, physician or registered nurse.
- Reinsert, convert and flush peripheral intermittent infusion devices.
When under the direction of an RN or licensed practitioner, an LPN-C may perform these activities for a pediatric client:
- Administer pain medications through a patient controlled administration pump if the medication has been commercially prepared, or prepared by a pharmacist, physician or registered nurse.
- Flush a peripheral intermittent infusion device.
Approved Medications. When approving medications for intravenous administration by an LPN-C, the RN or licensed practitioner must consider the following:
- Adverse consequences;
- How adverse consequences are manifested;
- How adverse consequences are measured;
- What intervention is required; and
- How intervention is applied.
Approved medications do not include:
- Blood and blood products;
- Antineoplastic agents;
- Oxytocics;
- Anti-arrhythmics; and
- Hyperalimentation.
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