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Difficulty: MediumAssignment, Delegation and Supervision

An emergency department nurse is preparing to transfer a stabilized client to an inpatient medical floor while simultaneously managing several new acute admissions. To optimize time and maintain client safety, the nurse enlists the assistance of an unlicensed assistive personnel (UAP). Which specific action should the nurse delegate to the UAP?

  1. A
    Demonstrating the proper technique for using crutches to a client preparing for discharge with an ankle sprain.
  2. B
    Reassessing the respiratory rate and pain level of a client who received intravenous morphine twenty minutes ago.
  3. Assisting a client with a simple closed forearm fracture in changing into a hospital gown prior to obtaining radiological imaging.Answer
  4. D
    Providing the initial oral fluid intake and feeding a newly admitted older adult who presents with acute delirium and lethargy.

Answer

Assisting a client with a simple closed forearm fracture in changing into a hospital gown prior to obtaining radiological imaging.
The registered nurse is responsible for the overall care plan but can delegate routine, non-invasive tasks for stable clients to the UAP. Assisting a client with a closed fracture to change clothes is a standard basic care task with highly predictable outcomes. It requires no nursing judgment, thereby falling safely within the UAP's scope of practice.

Step-by-Step Solution

1
Identify the client acuity and the established scope of practice for Unlicensed Assistive Personnel (UAP).
UAPs can perform standard, unchanging procedures on stable clients, such as activities of daily living (ADLs), hygiene, and positioning.
The National Council of State Boards of Nursing (NCSBN) dictates that tasks requiring nursing judgment, assessment, teaching, or evaluation cannot be delegated to a UAP.
2
Evaluate each available task assignment against the acronym EAT (Evaluate, Assess, Teach).
Demonstrating crutches constitutes teaching. Reassessing pain constitutes evaluation. Feeding a lethargic, delirious client requires an initial clinical assessment of swallowing ability and aspiration risk.
Identifying these core nursing process elements automatically excludes them from safe UAP delegation.
3
Select the remaining routine task.
Assisting a stable client with a closed fracture into a gown remains the only safe and appropriate delegation.
This task involves basic ADLs and poses minimal risk to the client, falling perfectly within the UAP scope of practice.

Key Concept

Delegation to Unlicensed Assistive Personnel (UAP) requires applying the Five Rights of Delegation and explicitly avoiding the delegation of nursing judgment, initial assessments, teaching, or evaluation.
Estimated Time:1m 0s
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Topics

Assignment, Delegation and Supervision

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