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Difficulty: MediumAssignment, Delegation and Supervision

While organizing the morning shift workload on a telemetry unit, a registered nurse (RN) is partnered with a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which assignments by the RN represent safe delegation practices? Select all that apply.

  1. Assigning the LPN to administer a scheduled oral beta-blocker to a client with chronic atrial fibrillation.Answer
  2. B
    Delegating the UAP to feed a client experiencing acute dysphagia following a recent stroke.
  3. C
    Instructing the LPN to create the initial discharge teaching plan for a client going home with a new colostomy.
  4. Directing the UAP to measure and record the vital signs of a stable client preparing for discharge.Answer
  5. E
    Asking the UAP to determine the oxygen saturation of a client who is suddenly reporting severe shortness of breath.
  6. Assigning the LPN to perform a routine dressing change using sterile technique for a healing abdominal incision.Answer

Answer

The appropriate delegation decisions are assigning the LPN to administer the oral beta-blocker, directing the UAP to measure vital signs for a stable client, and assigning the LPN to perform a routine sterile dressing change.
Safe delegation involves matching the task to the individual's scope of practice and the client's stability. LPNs are licensed to administer oral medications and perform sterile dressing changes on stable, established wounds. UAPs can safely perform routine, non-invasive tasks such as vital sign measurement on stable clients.

Step-by-Step Solution

1
Analyze each client's stability and the complexity of the required task.
Identified that the client with acute dysphagia and the client with sudden shortness of breath are high-risk and unstable.
The 'Right Circumstance' principle of delegation dictates that unstable clients or complex situations require direct RN care.
2
Evaluate the scope of practice for the LPN.
Determined that administering oral medications and performing routine sterile dressing changes are within the LPN's scope, but initiating a discharge teaching plan is not.
LPNs cannot perform initial teaching or nursing assessments, as these require the RN's clinical judgment.
3
Evaluate the scope of practice for the UAP.
Determined that measuring vital signs on a stable client is appropriate, but feeding a client with acute dysphagia or assessing an unstable client's respiratory status is unsafe.
UAPs may only perform routine, standard procedures on stable clients and cannot perform assessments or interventions requiring clinical judgment.

Key Concept

Delegation and Scope of Practice
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Topics

Assignment, Delegation and Supervision

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