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Zorluk: ZorAssignment, Delegation and Supervision

While overseeing operations on an acute behavioral health unit, the charge nurse must distribute specific client interactions between the primary registered nurses (RNs) and the mental health technicians (unlicensed assistive personnel or UAPs). Which client care task is safely and appropriately delegated to the mental health technician?

  1. A
    Evaluating the therapeutic effectiveness of a verbal de-escalation technique recently applied to a client exhibiting aggressive behavior.
  2. B
    Monitoring and documenting the emergence of fine hand tremors and diaphoresis in a client undergoing acute alcohol detoxification.
  3. Accompanying a client diagnosed with anorexia nervosa to the dining area and remaining with them for one continuous hour following the meal.Cevap
  4. D
    Exploring the underlying reasons for a sudden, dramatic improvement in mood in a client who was admitted with severe depressive symptoms.

Cevap

The correct assignment involves accompanying the client with anorexia nervosa to the dining area and remaining with them for one hour after the meal.
The correct choice describes implementing a standardized environmental safety protocol (one-to-one observation to prevent purging), which requires basic direct observation without the need for independent clinical analysis or therapeutic communication. This falls perfectly within the scope of practice for unlicensed assistive personnel.

Adım Adım Çözüm

1
Analyze each proposed task to determine if it involves the core elements of the nursing process, specifically assessment, clinical judgment, evaluation, or teaching.
Three of the tasks involve evaluation of an intervention, assessment of complex withdrawal symptoms, and therapeutic communication regarding suicide risk.
According to the NCSBN, the registered nurse cannot delegate tasks requiring independent nursing judgment or the components of the 'EAT' acronym (Evaluate, Assess, Teach).
2
Evaluate the remaining task regarding the client with anorexia nervosa.
This task involves strictly adhering to a defined environmental safety protocol (preventing purging post-meal) without requiring independent clinical analysis or therapeutic intervention.
Unlicensed assistive personnel are trained to maintain direct observation and ensure basic safety protocols, making this a highly appropriate and safe delegation.

Anahtar Kavram

The delegation of client care tasks must strictly adhere to the principles of the nursing process, where assessment, evaluation, and complex therapeutic communication are retained by the registered nurse, while routine environmental safety observations can be safely delegated to unlicensed personnel.
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