Leadership / Delegation Question #8

Question

The nurse is making assignments for the unlicensed assistant personnel (UAP). Which assignment would be most appropriate to assign the UAP?

Answers

  1. Providing bed bath for a client who is diabetic and on a ventilator.
    • Rationale:

      This answer is not correct because of the client’s multiple medical problems. A client with multiple comorbidities will require priority attention and a higher level of acuity of care provided by the registered nurse.

  2. Collecting a urine specimen from a foley catheter.
    • Rationale:

      This answer is not correct because collecting urine from an indwelling catheter is a sterile procedure only to be performed by a nurse. The UAP may empty a catheter bag, but not collect a urinary specimen from a urinary catheter.

  3. Bathing a client with emphysema who is having dyspneic episodes.
    • Rationale:

      This answer is not correct because even though a UAP can assist with bath, a client with dyspneic episodes is having an immediate problem and will require priority attention. Close monitoring of the client’s respiratory status during a bath will require care by the registered nurse.

  4. Ambulating a client who had a right CVA ten days ago.
    • Rationale:

      This answer is correct because the client is 10 days post CVA. This indicates he has a lower acuity and risks are much lower than the other clients. UAPs may assist stable clients with ambulation and mobilization. They are able to assist in turning the client, bathing, intake and output, oral care, linen changes, feeding and vital signs.

Overview

When delegating duties to UAPs, client acuity is to be taken into consideration. Never delegate a task for an unstable client. UAPs may assist stable clients with ambulation and mobilization.

Explanation

Learning Outcomes

When delegating to a UAP, the health condition of the client must be stable in order for the UAP to assist the client. Tasks that involve clients with a high level of acuity should not be delegated to the UAP. When delegating duties to UAPs, client acuity is to be taken into consideration. Never delegate a task for an unstable client. UAPs may assist stable clients with ambulation and mobilization. They are able to assist in turning the client, bathing, intake and output, oral care, linen changes, feeding and vital signs. They cannot perform invasive procedures, sterile procedures, and are not licensed to give medications. Assignments given to the UAP are usually performed with a predictable outcome and will not endanger the client’s well being. Delegation is an exercise of nursing judgement.

Test Taking Tip

The key to delegating tasks to unlicensed, even if usual tasks performed by a UAP (e.g., turning the client, bathing, intake and output, oral care, linen changes, feeding and vital signs) is to ask yourself if the client is stable. If the client is not stable, the condition is unpredictable and must be performed by a licensed nurse and potentially, only a RN.

Video Rationale