Cognitive Skill: Recognize Cues Scenario: The nurse manager informs the nurse that there is an investigation that may result in a malpractice lawsuit. Events and actions are displayed below. For liability to be established, four key elements (duty, breach of duty, harm, and proximate cause) must be present. Instructions: Use an X to indicate which element is represented by the actions and events. All should be used and may be used more than once. Breach of Proximate Actions and Events Duty Duty Harm Cause 7:00 RN assigns LPN/LVN to monitor an IV potassium infusion prescribed to infuse over 4 hours. 7:45 Patient reports pain (1/10) at the site. LPN/LVN assesses the site and says, "Potassium is irritating to the veins, some discomfort is expected." 8:30 Patient reports that pain (5/10) is increasing. LPN / LVN observes redness around insertion site, flushes IV with normal saline and notices that slight swelling oc- curs during flushing. Warm pack applied and nurse says, "Everything is fine. The warmth will relieve the pain." 10:00 Patient reports severe pain (9/10). Redness and swelling are markedly increased. LPN/ LVN stops infusion and notifies the RN. Several days later, extensive necrotic tissue damage is not- ed. The HCP informs the nurse manager that there may be permanent scarring or nerve damage