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Difficulty: MediumAssignment, Delegation and Supervision

A registered nurse (RN) is planning care for a client who is one day post-operative following a lumbar laminectomy. The client experiences generalized weakness and requires assistance with mobility. Which of the following tasks are appropriate for the RN to delegate to the unlicensed assistive personnel (UAP)? Select all that apply.

  1. Repositioning the client using the log-rolling technique alongside another staff memberAnswer
  2. Applying anti-embolism stockings to the client's lower extremitiesAnswer
  3. Emptying the closed-wound drainage device and documenting the volume collectedAnswer
  4. D
    Inspecting the lumbar surgical dressing for signs of clear fluid leakage
  5. E
    Explaining the rationale for maintaining a straight spinal alignment during position changes
  6. F
    Determining the effectiveness of the oral pain medication administered previously

Answer

The appropriate tasks to delegate to the UAP are repositioning the client using the log-rolling technique, applying anti-embolism stockings, and emptying the closed-wound drainage device to record the volume.
Tasks such as assisting with mobility (log-rolling), applying anti-embolism stockings, and recording output from a drain are routine, standard procedures with predictable outcomes. They do not require independent clinical judgment, making them safe to delegate to a UAP under RN supervision.

Step-by-Step Solution

1
Analyze the client's condition and the scope of practice for an unlicensed assistive personnel (UAP).
The client is stable but requires mobility assistance. UAPs can perform routine, standard care tasks that do not require clinical judgment.
Understanding the client's acuity and the UAP's limitations is the first step in safe delegation.
2
Evaluate each task against the NCSBN delegation guidelines, specifically checking for the E.A.T. criteria (Evaluate, Assess, Teach).
Tasks involving assessment (inspecting the dressing), teaching (explaining rationales), and evaluation (determining medication effectiveness) must be excluded.
The RN retains accountability for all clinical decision-making, assessments, and client education.
3
Select the remaining tasks that involve standard procedures and data collection.
Repositioning, applying stockings, and measuring drainage are identified as safe and appropriate for delegation.
These tasks have predictable outcomes and fall within the UAP's established role.

Key Concept

The RN cannot delegate tasks that require nursing judgment, specifically Evaluation, Assessment, and Teaching (E.A.T.). UAPs may perform routine tasks with predictable outcomes.
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Topics

Assignment, Delegation and Supervision

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