delegation practice q
The nurse is assigned a client with end-stage ovarian cancer with recurrent ascites, and the client is to undergo paracentesis. Which activity is best to delegate to an experienced licensed practical nurse (LPN/VN)? completing the client admission obtaining a paracentesis tray from central supply vital signs every 15 minutes after the paracentesis providing discharge instructions after the paracentesis
Correct response: vital signs every 15 minutes after the paracentesis Explanation: An experienced LPN/LVN would monitor and report vital signs to the RN. The paracentesis tray can be obtained by the unit clerk or unlicensed assistive personnel (UAP). The admission assessment and teaching require the RN's expertise and education.
A client is stabilized in the emergency department and moved to the neurologic intensive care unit with a diagnosis of spinal cord injury at level C4-C5. The nurse is working with an experienced unlicensed assistive personnel (UAP). Which items can the nurse delegate to the UAP? Select all that apply. Auscultate lungs every hour to detect decreased or absent breath sounds. Teach the client to breathe slowly and deeply and to use the incentive spirometer. Ensure that oxygen is flowing at 5 liters per minute by nasal cannula. Check the client's pulse oximetry reading every 1 hour. Assess for level of consciousness and shortness of breath.
Ensure that oxygen is flowing at 5 liters per minute by nasal cannula. Check the client's pulse oximetry reading every 1 hour. An experienced UAP would be able to make sure the oxygen is flowing, the setting is correct, and the cannula is correctly positioned; the UAP would also know how to measure oxygen saturation rate by pulse oximetry. Assessments, auscultation of lungs, and client teaching require additional education, training, and skill and are appropriate for the RN scope of practice.
The nurse is working with a client with rule-out abdominal aortic aneurysm (AAA) that reports severe, worsening back pain. The following have been ordered by the health care provider. Which action should the nurse delegate to the licensed practical/vocational nurse (LPN/VN)? inserting a urinary catheter administering pain medication by IV push measuring vital signs placing a second IV line
Correct response: inserting a urinary catheter Explanation: The LPN/VN's scope of practice includes placing a urinary catheter. To place IV catheters and administer IV drug, the LPN/VN would need additional education and training. The unlicensed assistive personnel (UAP) could measure the client's vital signs, with instructions from the nurse about what findings to report.
The nurse is making team assignments and is assigning tasks to the unlicensed assistive personnel (UAP). unit. What information should the nurse know before delegating tasks to the UAP? The UAP has previously completed and practiced the delegated activities. All nursing activities performed by the UAP should be directly supervised by a registered nurse. Some nursing activities performed by the UAP should be directly supervised by a registered nurse. The UAP's level of knowledge and comfort level in performing specific nursing activities should be considered.
Correct response: The UAP's level of knowledge and comfort level in performing specific nursing activities should be considered. Explanation: The RN is responsible for providing, delegating, and at times supervising others to ensure safe nursing care. They remain responsible when delegating nursing tasks to other members of the health care team. The nurse should delegate tasks in collaboration with the UAPs, considering their knowledge level and comfort when performing various aspects of care, regardless of whether the UAPs have previously completed these activities.
A nurse is finishing a shift on the pediatric unit. Because the shift is ending, which intervention takes priority? completing input and output recording for the shift documenting the care provided during the shift checking to see that client orders have been transcribed checking client pain levels for report to the next shift nurse
Correct response: documenting the care provided during the shift Explanation: Documentation should take top priority as this is the only way the nurse can legally claim that client interventions were performed. Checking client pain levels should be done throughout the shift and clients should be medicated so that they are not in need during busy change of shift times. Waiting until the end of the shift to review that client orders have been transcribed may lead to a delay in treatment and should be completed in a timely manner throughout the shift. Completing input and output recording can be assigned to an unlicensed assistive personnel (UAP) and should be delegated.
A registered nurse (RN) is receiving an admission to the medical-surgical unit. Which nursing responsibilities would be appropriate to delegate to the licensed practical/vocational nurse (LPN/VN) on the unit? Select all that apply. Performing the initial physical assessment and vital signs Collecting the IV pole and assessment equipment Assisting a client with incentive spirometry Contacting the health care provider and obtaining admission orders Preparing the bed and room for the admission
Preparing the bed and room for the admission Collecting the IV pole and assessment equipment Assisting a client with incentive spirometry The nurse must recognize the scope of practice in order to delegate. An LPN/VN can prepare the room, collect equipment, and assist clients with incentive spirometry under the LPN's Nurse Practice Act. An LPN/VN cannot do parts of the nursing process such as performing initital assessments or calling for admission orders. The ability of the LPN to perform some tasks, such as medication administration, can vary by state or province. Both the RN and LPN should understand the limits of what can be delegated.
The nursing team on an oncology unit consists of a registered nurse (RN), a licensed practical/vocational nurse (LPN/VN), and one unlicensed assistive personnel (UAP). Which client should be assigned to the RN? 52-year-old client with lung cancer admitted for acute dyspnea 28-year-old client being evaluated for a bone marrow transplant 65-year-old client diagnosed with endometrial cancer who underwent an abdominal hysterectomy 3 days ago 45-year-old client receiving tube feedings
Correct response: 52-year-old client with lung cancer admitted for acute dyspnea Explanation: Ongoing assessment by the RN is required to evaluate the client with dyspnea to monitor for potential deterioration of the respiratory status. If the RN is the care provider, the RN will have greater interaction with the individual client. The RN is responsible for the assessment of all the clients. The other clients would not be considered unstable, and maintaining a patent airway is always the priority in providing care. Care for the other clients could be assigned safely, according to the abilities of the LPN/VN and UAP.
The nurse can assign an unlicensed assistive personnel (UAP) to which client? A client who: has prostate cancer undergoing radiation implant seeding. was admitted to the hospital showing signs of progressive confusion. is 1 day postoperative following cranial surgery. had a newly created urinary diversion 3 days ago.
Correct response: had a newly created urinary diversion 3 days ago. Explanation: When delegating care, the nurse should consider the skill level of the UAP and the needs of the client. The UAP is able to assist with activities of daily living and basic care activities. The client who had surgery to establish a urinary diversion 3 days ago is the most stable of the clients and can be assigned to the UAP for basic care. The client with cranial surgery is 1 day postoperative and will require frequent neurological assessment; this client should be assigned to a registered nurse. The client with a radiation seeding is on radiation precautions and should be assigned to a registered nurse. The client showing signs of progressive confusion is the least stable and requires direct care by a nurse.
The nurse assigns an unlicensed assistive personnel (UAP) to provide care for a client with peptic ulcer disease. Concerned about possible ulcer perforation, the nurse should instruct the UAP to report to the nurse immediately if the client has: constipation. confusion. severe abdominal pain. an elevated pulse.
Correct response: severe abdominal pain. Explanation: A sign of ulcer perforation is the onset of sudden, severe abdominal pain. The nurse should instruct all UAPs to report this symptom immediately because a perforated ulcer is a medical emergency. An elevated pulse and confusion may occur for various reasons; the UAP should report all vital signs, but the severe pain must be brought to the nurse's attention immediately. Constipation will not require immediate intervention.
