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Difficulty: MediumAssignment, Delegation and Supervision

Midway through the day shift on an active gastroenterology unit, a registered nurse (RN) is coordinating client care tasks with a licensed practical nurse (LPN/VN) and an unlicensed assistive personnel (UAP). Which of the following task assignments are appropriate for the RN to make? Select all that apply.

  1. Instructing the UAP to record the color and total volume of drainage from a client's nasogastric tube canister.Answer
  2. Assigning the LPN/VN to administer a scheduled subcutaneous injection of enoxaparin to a client awaiting discharge.Answer
  3. C
    Directing the UAP to evaluate whether a client's incisional pain has decreased thirty minutes after receiving oral analgesics.
  4. Asking the LPN/VN to reinforce low-residue dietary guidelines with a client who received their primary nutritional education from the RN yesterday.Answer
  5. E
    Delegating the initial admission assessment of a client who just arrived from the emergency department with acute diverticulitis to the UAP.
  6. F
    Instructing the UAP to determine which of two newly admitted clients requires immediate medical attention based on their initial vital signs.

Answer

The correct task assignments include having the UAP record nasogastric tube drainage, assigning the LPN/VN to administer a scheduled subcutaneous enoxaparin injection, and asking the LPN/VN to reinforce previously taught dietary guidelines.
The appropriate delegations follow the core principles of the National Council of State Boards of Nursing (NCSBN). The RN may delegate standard, predictable procedures to competent team members. Reinforcing education that was already initiated by the RN falls safely within the scope of practice for an LPN/VN. Similarly, administering subcutaneous injections, such as enoxaparin, is a standard task for an LPN/VN caring for a stable client. Unlicensed assistive personnel (UAP) can safely perform routine data collection and standard procedures on stable clients, which includes measuring and documenting the volume and color of drainage from a nasogastric tube. None of these correct tasks involve initial assessment, primary teaching, or clinical evaluation.

Step-by-Step Solution

1
Analyze the client acuity and the nature of each task proposed in the assignments.
Identified tasks involving data collection, medication administration, teaching, assessment, and evaluation.
Delegation requires matching the complexity of the task with the competency and legal scope of practice of the healthcare team member.
2
Apply the core principles of delegation, recalling that the RN cannot delegate clinical judgment, evaluation, or primary teaching.
Tasks requiring clinical assessment, triage decision-making, and outcome evaluation are flagged as inappropriate for delegation.
These tasks represent core RN responsibilities that ensure client safety and cannot be legally transferred.
3
Match the remaining routine tasks to the documented scope of practice for the LPN/VN and UAP.
Routine medication administration, reinforcement of existing teaching, and basic output measurement are confirmed as appropriate delegations.
Standard, predictable procedures on stable clients are safely within the scope of practice for LPN/VNs and UAPs.

Key Concept

Delegation Principles and Scope of Practice
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Topics

Assignment, Delegation and Supervision

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