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Difficulty: MediumAssignment, Delegation and Supervision

While organizing the morning workflow on a respiratory step-down unit, the registered nurse (RN) prepares to assign tasks to the unit's Unlicensed Assistive Personnel (UAP). Which of the following tasks can the RN safely delegate to the UAP? Select all that apply.

  1. Assisting a client with chronic obstructive pulmonary disease (COPD) to transfer from the bed to a resting chairAnswer
  2. B
    Demonstrating the proper technique for using an incentive spirometer to a newly admitted client
  3. Recording the routine morning vital signs for a client who is two days post-thoracentesis and clinically stableAnswer
  4. D
    Evaluating the respiratory status of a client following an albuterol nebulizer treatment
  5. Measuring and documenting the total urine output from a bedside commode for a client with cor pulmonaleAnswer
  6. F
    Determining whether a client with a tracheostomy requires PRN airway suctioning based on audible secretions

Answer

The correct tasks to delegate include assisting the client with COPD to transfer, recording vital signs for the stable post-thoracentesis client, and measuring urine output for the client with cor pulmonale.
The RN can safely delegate standard, unchanging procedures and activities of daily living for stable clients. Assisting with mobility, recording routine vital signs for a client with a predictable baseline, and measuring urine output are well within the UAP's scope of practice.

Step-by-Step Solution

1
Identify the standard scope of practice for Unlicensed Assistive Personnel (UAP).
The UAP scope includes basic patient care, routine vital signs, hygiene, and measuring intake/output for stable clients.
Delegation must follow the Five Rights, specifically the right task and the right person.
2
Analyze each proposed task to ensure it does not require the nursing process (assessment, diagnosis, planning, implementation of teaching, or evaluation).
Demonstrating equipment use (teaching), evaluating treatment response (evaluation), and determining the need for suctioning (assessment) violate these rules.
Tasks requiring specialized education, licensure, and independent clinical judgment must remain with the RN.
3
Select the tasks that involve routine, predictable care for clinically stable clients.
Transferring a client, documenting routine vital signs on a stable client, and measuring output are correctly selected.
These tasks are highly structured, involve minimal risk, and fall safely within the capabilities of the UAP.

Key Concept

Delegation of Care to Unlicensed Assistive Personnel (UAP)
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Topics

Assignment, Delegation and Supervision

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