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Difficulty: MediumAssignment, Delegation and Supervision

An experienced registered nurse (RN) is coordinating client assignments on a respiratory care unit. The care team includes the RN, a licensed practical nurse (LPN), and an unlicensed assistive personnel (UAP). Which delegation decision by the RN ensures safe client care?

  1. Allowing the LPN to suction the established tracheostomy of a stable client requiring routine airway clearance.Answer
  2. B
    Having the UAP explain the rationale for strict contact precautions to the family members of a newly admitted client.
  3. C
    Requesting the UAP to investigate the underlying reason for a sudden decrease in a client's oxygen saturation.
  4. D
    Asking the UAP to gauge the effectiveness of an intravenous diuretic by analyzing the client's hourly urine output trends.

Answer

The correct delegation is allowing the LPN to suction the established tracheostomy of a stable client.
The RN demonstrates safe delegation by assigning the LPN to perform tracheostomy suctioning on a stable client. LPNs possess the clinical training to perform procedural tasks, including sterile procedures and maintaining established airways, in predictable and stable situations.

Step-by-Step Solution

1
Evaluate the scope of practice for the Unlicensed Assistive Personnel (UAP).
UAPs cannot perform tasks requiring nursing judgment, such as teaching families, assessing sudden clinical changes, or evaluating medication effectiveness.
According to the principles of delegation, the RN cannot delegate the core components of the nursing process (assessment, planning, teaching, and evaluation) to unlicensed staff.
2
Evaluate the scope of practice for the Licensed Practical Nurse (LPN).
The LPN is qualified to perform procedural tasks, such as suctioning an established tracheostomy, for a medically stable client.
LPNs have the required education and licensure to care for stable clients with predictable outcomes and can perform sterile or invasive procedures under RN supervision.
3
Identify the safest and most appropriate assignment among the options.
The only safe delegation is assigning the tracheostomy suctioning to the LPN.
All other options involve delegating non-delegable RN responsibilities (teaching, assessment, and evaluation) to a UAP.

Key Concept

Assignment, Delegation and Supervision
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Topics

Assignment, Delegation and Supervision

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