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Difficulty: MediumAssignment, Delegation and Supervision

A clinical team on a nephrology unit consists of a registered nurse (RN), a licensed practical nurse (LPN/VN), and an unlicensed assistive personnel (UAP). As the shift begins, the RN is determining which client care activities can be safely assigned. Which of the following tasks is most appropriate to delegate to the UAP?

  1. Recording the morning weight and emptying the indwelling urinary catheter bag for a client with chronic kidney disease.Answer
  2. B
    Assisting with the initial oral feeding for a client who was admitted overnight with a stroke and residual dysphagia.
  3. C
    Explaining the purpose of a prescribed low-potassium diet to a client newly diagnosed with end-stage renal disease.
  4. D
    Assessing the clarity and color of peritoneal dialysis effluent as it drains into the collection bag.

Answer

Recording the morning weight and emptying the indwelling urinary catheter bag for a client with chronic kidney disease.
The correct answer involves standard, routine, and safely predictable tasks on a stable client. UAPs are trained to measure vital signs, record daily weights, and measure intake and output. These activities do not require independent clinical judgment, assessment, or teaching.

Step-by-Step Solution

1
Analyze each proposed task to determine if it requires nursing assessment, clinical judgment, or initial teaching (the EAT acronym: Evaluate, Assess, Teach).
Three of the tasks involve assessment, high-risk evaluation, or initial teaching.
The National Council of State Boards of Nursing (NCSBN) strictly prohibits delegating clinical judgment and initial assessments to UAPs.
2
Evaluate the client's stability and the routine nature of the task.
Recording a daily weight and emptying a catheter are standard, unchanging procedures on a stable client.
Tasks delegated to UAPs must have predictable outcomes and not require ongoing nursing judgment during execution.
3
Select the task that securely fits within the UAP scope of practice.
The correct delegation choice is the routine measurement of weight and urine output.
This maintains client safety and adheres to legal delegation guidelines.

Key Concept

Delegation of Routine Tasks vs. Nursing Judgment
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Topics

Assignment, Delegation and Supervision

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