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Difficulty: MediumAssignment, Delegation and Supervision

After a sudden influx of admissions to the telemetry unit, the healthcare team must reassign several client care activities. The team consists of a registered nurse (RN) and an unlicensed assistive personnel (UAP). Which of the following tasks is most appropriate for the RN to safely delegate to the UAP?

  1. Emptying a urinary catheter drainage bag and documenting the volume for a client receiving a continuous diuretic infusion.Answer
  2. B
    Assessing the peripheral pulses and capillary refill of a client who recently returned from a cardiac catheterization.
  3. C
    Providing initial instructions on sodium and fluid restriction guidelines to a client newly diagnosed with heart failure.
  4. D
    Feeding a client who has begun coughing frequently and pocketing food while eating breakfast.

Answer

The most appropriate task to delegate to the UAP is emptying the urinary catheter drainage bag and documenting the volume.
Measuring and recording intake and output, including emptying a urinary drainage bag, is a standard, routine task that falls safely within the scope of practice for an unlicensed assistive personnel (UAP). Although the client is receiving a continuous diuretic infusion, the act of measuring the urine does not require clinical judgment. The RN will subsequently use the recorded data to evaluate the effectiveness of the diuretic therapy.

Step-by-Step Solution

1
Recall the principles of delegation and the established scope of practice for an unlicensed assistive personnel (UAP).
UAPs can perform routine, standard procedures on stable clients, such as hygiene care, ambulation assistance, and measuring intake and output.
Identifying the UAP's scope is the first step in determining safe delegation.
2
Apply the NCSBN delegation guidelines regarding tasks that must remain with the registered nurse.
The RN cannot delegate Evaluation, Assessment, or Teaching. This eliminates the options involving the assessment of pulses and teaching about fluid restrictions.
These tasks require specialized nursing knowledge and clinical judgment.
3
Evaluate the clinical stability of the clients in the remaining options.
A client with new-onset coughing and pocketing of food is exhibiting signs of acute dysphagia, making them unstable and at high risk for aspiration. This requires direct RN assessment. The client with the catheter is stable for the specific task of emptying the bag.
Delegation requires the 'right circumstance,' meaning the client must be stable and the outcome of the task predictable.

Key Concept

Delegation and UAP Scope of Practice
Estimated Time:1m 0s
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Topics

Assignment, Delegation and Supervision

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