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Difficulty: HardAssignment, Delegation and Supervision

An experienced registered nurse (RN) is leading a shift on an acute infectious disease unit, collaborating with a licensed practical nurse (LPN/VN) and an unlicensed assistive personnel (UAP). To ensure safe and effective client care, which of the following specific task assignments demonstrates appropriate delegation principles?

  1. Designating the LPN/VN to administer scheduled oral antimicrobial therapy to a hemodynamically stable client recovering from localized cellulitis.Answer
  2. B
    Relying on the UAP to instruct a client carrying methicillin-resistant Staphylococcus aureus (MRSA) about the necessity of strictly adhering to their home medication regimen.
  3. C
    Dispatching the LPN/VN to assess a client who just exhibited a sudden oxygen desaturation to 85% to decide if emergency medical intervention is required.
  4. D
    Having the UAP assist a client with a confirmed Clostridioides difficile infection to the bathroom, while advising the use of an alcohol-based hand rub upon exiting the isolation room.

Answer

The appropriate delegation is assigning the LPN/VN to administer scheduled oral medications to a stable client with cellulitis.
Administering routine oral medications to a clinically stable client with a predictable condition (such as recovering cellulitis) aligns perfectly with the scope of practice for a Licensed Practical Nurse (LPN/VN). It meets all criteria for safe delegation, freeing the RN to manage more complex and unstable clients on the unit.

Step-by-Step Solution

1
Analyze the acuity and stability of each client presented in the options.
The client with cellulitis is stable. The client experiencing sudden oxygen desaturation is highly unstable and requires immediate advanced assessment.
Delegation decisions must prioritize client safety; unstable clients require the RN's advanced clinical judgment and cannot be delegated to an LPN/VN or UAP.
2
Evaluate the scope of practice for the assigned tasks in the remaining options.
Administering oral medications is within the LPN/VN scope. However, client education on medication regimens is strictly an RN responsibility and outside the UAP scope.
The 'Right Task' and 'Right Person' principles of delegation explicitly prohibit assigning initial health teaching to unlicensed personnel.
3
Assess the infection control instructions provided during the delegation to the UAP.
Advising a UAP to use an alcohol-based hand rub for a client with Clostridioides difficile is a critical clinical error, as soap and water are mandatory for spore-forming bacteria.
The 'Right Direction/Communication' principle requires the RN to provide safe, scientifically accurate instructions regarding transmission-based precautions.

Key Concept

Delegation and Scope of Practice (The Five Rights of Delegation)
Estimated Time:1m 30s
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Topics

Assignment, Delegation and Supervision

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