Which category of medications should the RN administer that must not be delegated to LPNs when caring for a patient on mechanical ventilation?

Administering neuromuscular blocking agents is a critical nursing responsibility that requires a thorough understanding of the patient's condition and the effects of the medication. These agents are used to induce paralysis, which can be necessary in mechanically ventilated patients to facilitate ventilation and prevent the patient from fighting the ventilator. Due to the complexity of managing these medications, including monitoring for proper dosage, potential side effects, and the patient's response, the Registered Nurse (RN) must possess the comprehensive knowledge and skills that can be beyond the scope of practice for Licensed Practical Nurses (LPNs).

RNs are required to assess the patient’s condition continuously, evaluate the effectiveness of the neuromuscular blockade, and manage any complications that may arise during administration. This level of assessment and responsibility is integral to ensuring patient safety and requires the higher level of critical thinking that RNs are trained for. Therefore, administering neuromuscular blocking agents is a task that must remain within the RN's scope of practice, primarily due to the need for intensive monitoring and evaluation associated with their use.