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Difficulty: MediumAssignment, Delegation and Supervision

While observing care delivery on a progressive care floor, the nurse educator evaluates a registered nurse (RN) who is distributing tasks to an unlicensed assistive personnel (UAP). Which delegation decision by the RN demonstrates safe and effective practice?

  1. A
    Telling the UAP to obtain the first set of vital signs for a newly admitted client experiencing unstable angina.
  2. B
    Delegating the feeding of a client who has a recent history of aspiration pneumonia and active dysphagia.
  3. Instructing the UAP to measure and record the hourly urine volume for a client on a continuous diuretic drip.Answer
  4. D
    Having the UAP review the low-sodium diet pamphlet with a client preparing for discharge.

Answer

Instructing the UAP to measure and record the hourly urine volume for a client on a continuous diuretic drip is the correct delegation decision.
Measuring and recording urine volume is a routine, non-invasive task that does not require nursing judgment, making it entirely appropriate for a UAP. While the UAP documents the volume, the RN maintains the responsibility of analyzing the trended output to determine if the continuous diuretic drip is clinically effective.

Step-by-Step Solution

1
Identify the scope of practice for unlicensed assistive personnel (UAP).
UAP scope includes routine, non-invasive tasks such as measuring vital signs on stable clients, recording intake and output, and assisting with basic activities of daily living.
Understanding the boundaries of UAP practice is required to ensure safe delegation.
2
Evaluate each task to ensure it does not violate the core principles of delegation.
Tasks requiring assessment, clinical judgment, teaching, or evaluation (EAT) must be retained by the RN.
Delegating complex or high-risk tasks jeopardizes client safety and violates nursing practice acts.
3
Determine which task involves routine data collection without the need for interpretation.
Recording hourly urine volume is a standard measurement task that does not require independent clinical judgment, making it safe to delegate.
The UAP can safely collect the data, while the RN remains responsible for analyzing the output to evaluate the effectiveness of the diuretic.

Key Concept

Delegation and Scope of Practice for UAP
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Topics

Assignment, Delegation and Supervision

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