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Difficulty: MediumAssignment, Delegation and Supervision

A client who sustained an ischemic stroke 48 hours ago is clinically stable but experiences right-sided hemiparesis. The registered nurse (RN) is coordinating care with an unlicensed assistive personnel (UAP). Which task is most appropriate for the RN to delegate to the UAP?

  1. A
    Evaluating the client's tolerance to a pureed diet during their first meal following a swallow study
  2. B
    Modifying the client's turning schedule after noting a newly formed non-blanchable red area on the sacrum
  3. Assisting the client with personal hygiene and applying barrier cream to intact perineal skinAnswer
  4. D
    Educating the client's family members on the proper technique for passive range-of-motion exercises

Answer

Assisting the client with personal hygiene and applying barrier cream to intact perineal skin.
The registered nurse can safely delegate standard, unchanging, and routine procedures to the UAP for a clinically stable client. Assisting with personal hygiene and applying barrier cream to intact skin are standard activities of daily living (ADLs) that do not require independent nursing judgment, making this an appropriate delegation.

Step-by-Step Solution

1
Identify the client's stability and current needs.
The client is stable 48 hours post-stroke but has right-sided hemiparesis, requiring assistance with basic activities of daily living.
Delegation requires assessing the client's overall condition to ensure assigned tasks are safe and predictable.
2
Analyze each proposed task against the UAP scope of practice.
Hygiene and basic skin protection are routine tasks, while evaluation, teaching, and care plan modification require RN licensure.
The RN cannot delegate nursing judgment, assessment, teaching, or evaluation.

Key Concept

Delegation to Unlicensed Assistive Personnel (UAP)
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Topics

Assignment, Delegation and Supervision

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