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Difficulty: MediumAssignment, Delegation and Supervision

An emergency department (ED) registered nurse (RN) is working with an unlicensed assistive personnel (UAP) during a high-volume shift. Which of the following client care activities is most appropriate for the RN to delegate to the UAP?

  1. A
    Evaluating a newly admitted client's response to an antipyretic medication administered for a high fever.
  2. B
    Providing discharge instructions regarding wound care to a client who received sutures for a laceration.
  3. Obtaining a clean-catch urine specimen from a clinically stable client presenting with symptoms of a mild urinary tract infection.Answer
  4. D
    Monitoring a client with facial swelling and audible stridor who is waiting to be evaluated by the healthcare provider.

Answer

The most appropriate task to delegate to the UAP is obtaining a clean-catch urine specimen from a clinically stable client.
The correct delegation decision involves a routine, standard task (collecting a urine specimen) for a client who is clinically stable. This task has a predictable outcome, does not require nursing judgment, and safely falls within the UAP scope of practice.

Step-by-Step Solution

1
Analyze the client and task in each option to determine if it requires nursing assessment, clinical judgment, teaching, or evaluation.
Three of the options involve evaluating medication response, teaching, or monitoring an unstable airway.
The National Council of State Boards of Nursing (NCSBN) dictates that tasks involving the nursing process cannot be delegated to unlicensed personnel.
2
Evaluate the clinical stability of the clients described in each option.
The client with stridor is critically unstable and has a compromised airway. The client providing a urine specimen is clinically stable.
Delegation is only safe when the client's condition is stable and predictable.
3
Select the task that involves a standard, routine procedure on a stable client without requiring clinical decision-making.
Obtaining a clean-catch urine specimen is identified as the correct delegated task.
This task falls safely within the UAP's scope of practice.

Key Concept

The registered nurse (RN) must not delegate tasks that involve the nursing process, including assessment, clinical judgment, teaching, or evaluation. Furthermore, clients with unstable conditions or acute changes in status must remain under the direct care of the RN.
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Topics

Assignment, Delegation and Supervision

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