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Difficulty: MediumAssignment, Delegation and Supervision

While managing care for a caseload of clients on a renal step-down unit, the registered nurse (RN) directs an unlicensed assistive personnel (UAP) to assist with morning activities. Which of the following tasks is safe and appropriate to delegate to the UAP?

  1. A
    Checking the patency and presence of a thrill on a newly placed arteriovenous (AV) fistula.
  2. B
    Explaining the rationale for strict fluid restriction to a client diagnosed with end-stage renal disease.
  3. Recording the exact amount of oral fluid consumed by a client undergoing continuous bladder irrigation.Answer
  4. D
    Monitoring a client's respiratory status for fifteen minutes following the administration of intravenous opioids.

Answer

Recording the exact amount of oral fluid consumed by a client undergoing continuous bladder irrigation.
The correct task involves standard data gathering (measuring and documenting oral intake) on a stable client. This specific action does not require independent nursing judgment, clinical assessment, or evaluation. Therefore, it falls safely within the established scope of practice for unlicensed assistive personnel.

Step-by-Step Solution

1
Identify the established scope of practice for an unlicensed assistive personnel (UAP).
UAPs can perform standard, unchanging procedures and gather basic physiological data, such as vital signs, hygiene, and intake/output measurements.
Understanding scope of practice is the foundation of the Five Rights of Delegation.
2
Evaluate each task against the NCSBN delegation guidelines regarding what a registered nurse cannot delegate.
The RN cannot delegate Evaluation, Assessment, or Teaching (EAT).
These functions require specialized nursing knowledge and independent clinical judgment.
3
Analyze the specific options to determine which task falls outside the restricted EAT categories.
Checking a fistula is an assessment, explaining rationale is teaching, and monitoring post-medication response is evaluation. Recording fluid intake is routine data collection.
Routine data collection does not require clinical decision-making, making it the only safe choice.

Key Concept

Delegation to Unlicensed Assistive Personnel (UAP)
Estimated Time:1m 0s
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Topics

Assignment, Delegation and Supervision

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