Delegation

what types of IV drugs should not be delegated even if its a piggy back?

- Blood transfusion - other blood products; platelets, plasma - Central line drugs; chemo, TPN.

what is the difference between delegation and dumping?

- Dumping; giving someone an undesirable task or giving someone who is productive even more work.

what is the role of LPN vs RN in regards to assessment?

- RN completes primary or comprehensive assessment - LPN completes focused or secondary assessment.

what delegating a skill or activity that is outside of the traditional role and & basic responsibilities of the delegatee's current job, what should the nurse keep in mind?

- That the UAP/LPN obtains additional education & training and shows competency in the new skill. - The RN must maintain overall accountability but the UAP/LPN bears the responsibility for the task. - They must be within the parameters of the UAP/LPN's scope of practice.

what skills can be delegated to the UAPs? VAPER

- Vitals - ambulation for stable clients - repositioning - Eating except swallow precautions and NPO - Recording Intakes and Outputs

A nurse enters a client's room and finds the client pulseless. The family has requested a do-not-resuscitate (DNR) order from the provider, but he has not written the order yet. Which of the following actions should the nurse take? A. Call the emergency response team.• B. Seek immediate help from the risk manager.• C. Call the provider for a stat DNR order.• D. Respect the family's wishes and do n

A. Call the emergency response team.

Can LPNs take orders/ delegations within their scope of practice from the health care provider?

yes

can LPN's assign to UAP's

yes

can LPNs assign to other LPN's?

yes

A home health care nurse is visiting an older adult client who tells the nurse thatshe is feeling tired, is unable to shop for groceries, and would like the nurse toshop for her. Shopping and performing personal errands for the client is prohibitedin the nurse's job description. Which of the following is an appropriate nursingresponse?

"Let's look at some other resources to solve this problem.

what does the right person entail

- assessing the assistant's knowledge, experience and skill level b4 delegation

what does the LPN do with the results of focused assessments?

- compares data to normal findings and to patients current health status - reports changes to the RN

what skills can be delegated to the LPN?

- maintenance of NG tube feeds - G tubes - Foley catheterization - Glucose checks - Iv PIGGYBACK meds, no titration of rate changes - Calculation of flow rates - IM and sub-cue injections - monitoring of blood transfusion

what does the right circumstance of delegation entail and what are the keywords for unstable patients?

- new admission - returning to the floor post-surgery procedure - Sudden change in status - first time doing anything - Primary assessment and first assessment

what should RN's not delegate? UEATI

- unstable clients & unstable vitals, blood sugar, and lab values - Evaluation of trending or interpreting lab values and vital signs. - Assessments; initial first, primary, post-op & new admission. - Teaching; Initial, first, primary education. LPNs can reinforce or remind (secondary). - IV push medications; LPNs can only hang piggyback

A nurse manager is reviewing the admission history of four adults who were admitted to the medical-surgical unit during the shift. Which of the following situations is the nurse required to disclose information to an outside agency about the client or the client's circumstances? A. A dependent adult admitted for the treatment of a spiral fracture.• B. A young adult client admitted for asthma and has track marks that may indicateIV drug abuse.• C. A young adult client admitted for acute glomerulonephritis following a viralinfection.• D. An emancipated minor who has acute appendicitis and wants to leave the facilitywithout treatment. AA. A dependent adult admitted for the treatment of a spiral fracture.• B. A young adult client admitted for asthma and has track marks that may indicateIV drug abuse.• C. A young adult client admitted for acute glomerulonephritis following a viral infection.• D. An emancipated minor who has acute appendicitis and wants to leave the facility without treatment.

A. A dependent adult admitted for the treatment of a spiral fracture

When can LPNs teach, assess and monitor?

As secondary assessment reinforcement of teaching Follow up monitoring.

what is the an assignment as opposed to delegation?

Assignment are routine care, activities, and procedures that are within the authorized scope of practice of the RN or LPN/VN or part of the routine functions of the UAP

A nurse is caring for a client who is scheduled to have surgery.In preparing the client for surgery, which of the followingactions is considered outside the nurse's responsibilities?• A. Assessing the current health status of the client• B. Explaining the operative procedure, risks, and benefits• C. Reviewing preoperative laboratory test results• D. Ensuring that a signed surgical consent form was completed

B.

A client who fell and broke his hip while being assisted to the bathroom by anurse states he plans to sue the nurse. The nurse should know that, in a legalproceeding, the standard that will be used to determine if the nursewas negligentis which of the following?• A. An expert nurse provides testimony that the nurse should have handled thesituation differently.• B. Another staff nurse provides testimony about how a reasonable, prudent nursewould have handled the situation.• C. The client's attorney states that injury to the client could have been prevented.• D. The client's provider testifies the nurse was at fault for the injury.

B. Another staff nurse provides testimony about how a reasonable, prudent nurse

A nurse accidentally administers the wrong medication to a client, which results in a severe allergic reaction and prolongs the client's hospitalization. The client could rightfully sue the nurse for which of the following?• A. Battery• B. Assault• C. Malpractice• D. Abuse

C. Malpractice

what is the responsibility of the nurse surrounding assignments rather than delegations?

RNs are still responsible for ensuring that an assignment is carried out completely and correctly.

what does right supervision entail in delegation?

The RN is accountable for evaluating the outcome of the task that was delegated. The RN must follow up and reassess.

An RN delegates a routine task to the UAP, would there be legal consequences for the nurse if there is negligence by the UAP?

The RN may be liable if negligent in supervising the UAP or following up after the UAP performed the task.

A client was newly admitted for MI. Appropriate activities to assign to UAP include all except; a. Teaching about foods that are high in sodium b. recording I and O c, Ambulation assistance d. Reporting to the nurse that the patient complained of chest pain.

a. Teaching about foods that are high in sodium

which of the following should the nurse delegate to the LPN? Select all that apply; a. adminiter subcue insulin b. assess client returning after an ECRP procedure c. starting a primary Iv med d. reinforce teaching for a client before surgery e. urinary catheterization f. secondary assessment of chest pain

a. administer sub-cue insulin d. reinforce teaching for a client before surgery e. urinary catheterization f. secondary assessment of chest pain

what are the 5 rights of delegation

right task right circumstance right person right direction/communication right supervision/evaluation