Two clients are admitted to the unit at the same time. One client is an older adult client with a possible overdose of acetaminophen who has a heart rate of 130 beats/minute and a blood pressure of 86/40 mm Hg. The other is an older adult client with a long history of chronic obstructed pulmonary disease (COPD) and a pulse oximeter reading of 80% oxygen saturation. Which assignment is the best use of available staff?

A. A registered nurse (RN) to admit the client with COPD while a practical nurse (PN) checks the vital signs of the client with a possible overdose: The client with a possible acetaminophen overdose is hemodynamically unstable, showing hypotension and tachycardia. Assigning a PN to check vital signs is unsafe because the client’s condition requires immediate, comprehensive assessment and potentially rapid interventions that are within the RN’s scope of practice. B. A PN to monitor the client with COPD while an RN admits the client with a possible overdose: The client with a possible acetaminophen overdose is critically ill, with hypotension and tachycardia, requiring the RN’s advanced assessment and intervention skills. The client with COPD is stable enough for monitoring by a PN while the RN focuses on the higher-acuity patient. C. An RN to care for both clients since their care requires skills beyond the scope of practice for a PN: While having one RN for both clients ensures safety, it is not an efficient use of staff. Delegation allows the RN to manage the higher-acuity client while a PN safely monitors the more stable patient, optimizing care without compromising patient safety. D. Two PNs to admit the clients since frequent vital signs will need to be taken on them both: Both clients require assessment skills and interventions that may exceed the scope of practice of a PN, especially the unstable client with hypotension and tachycardia. Assigning two PNs would place the critically ill client at significant risk and is unsafe.