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Difficulty: MediumAssignment, Delegation and Supervision

A charge nurse is coordinating care on a busy renal and metabolic disorders unit. The nursing team includes a registered nurse (RN) and an unlicensed assistive personnel (UAP). Which task is most appropriate for the RN to delegate to the UAP?

  1. A
    Evaluating the effectiveness of a PRN analgesic administered for flank pain
  2. B
    Explaining fluid restriction guidelines to a client with chronic kidney disease
  3. Measuring the morning capillary blood glucose level for a stable client with type 2 diabetesAnswer
  4. D
    Assessing a new arteriovenous (AV) fistula site for the presence of a thrill and bruit

Answer

Measuring the morning capillary blood glucose level for a stable client with type 2 diabetes
Measuring capillary blood glucose on a stable client is a routine, standardized procedure with predictable outcomes that falls securely within the established scope of practice for a trained UAP. It does not require independent nursing judgment.

Step-by-Step Solution

1
Identify the legal and professional scope of practice for unlicensed assistive personnel (UAP).
UAPs are permitted to perform routine, standardized tasks with predictable outcomes on stable clients.
Delegation must adhere to the 'Five Rights of Delegation', ensuring the right task is assigned to the right person based on their competency and role.
2
Analyze each option to determine if it requires the nursing process (assessment, diagnosis, planning, implementation of teaching, or evaluation).
Evaluating pain medication, explaining fluid guidelines, and assessing an AV fistula all involve the nursing process and clinical judgment.
The RN is legally accountable for the nursing process and cannot delegate tasks requiring specialized nursing knowledge to unlicensed personnel.
3
Select the task that does not require independent nursing judgment.
Measuring a capillary blood glucose level for a stable client is identified as the correct task to delegate.
This is a standard procedure with a predictable outcome that a trained UAP can safely perform.

Key Concept

Delegation and Scope of Practice based on the Nursing Process
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Topics

Assignment, Delegation and Supervision

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