ID
712613
Question
The nursing student is reviewing tasks that are appropriate to delegate to unlicensed assistive personnel (UAP). Which of the following tasks does the student correctly choose? Select all that apply.
Answers
- Taking vital signs on a client who is 2 days post-op
- Rationale:
This is the correct answer because a client who is two days post-op is considered stable and, therefore, this is an appropriate task to delegate to UAP. It would not be appropriate to delegate vital signs to the UAP if the client had recently returned from surgery. UAP can take vital signs on stable clients, and they can assist with activities of daily living, hygiene needs, linen changes, positioning, and other simple tasks
- Rationale:
- Picking up a client’s prescription for metoprolol from the pharmacy
- Rationale:
This is the correct answer because retrieving a non-controlled drug from the pharmacy is a simple task that UAP are qualified to perform. Appropriate tasks to delegate to UAPs include uncomplicated, non-sterile tasks. UAP can take vital signs on stable clients, and they can assist with activities of daily living, hygiene needs, linen changes, positioning, and other simple tasks
- Rationale:
- Taking vital signs on a client that just returned from PEG tube placement
- Rationale:
This is not the correct answer because a client that just returned from PEG tube placement is not considered stable. The registered nurse should obtain the first set of vital signs after a procedure.
- Rationale:
- Recording the intake and output on a client with a Foley catheter
- Rationale:
This is the correct answer because recording intake and output on a client with a Foley catheter is within the scope of practice for UAP. UAP can measure and record intake and output. However, UAP are not expected to evaluate the findings (i.e. determine that the client may be experiencing fluid overload due to a significantly higher intake than output).
- Rationale:
- Assigning lunch times to the staff working on the floor for the day
- Rationale:
This is not the correct answer because assigning lunch times to the staff working on the floor is not a role that the UAP should fill. This is a management duty and should be performed by the unit manager or charge nurse, both of whom are qualified to make assignments to the floor staff.
- Rationale:
Overview
The student correctly chooses appropriate tasks to delegate to UAP including taking vital signs on a client that is 2 days post-op, picking up a client’s prescription for metoprolol, and recording the intake and output on a client with a Foley catheter.
Learning Outcomes
Appropriate tasks to delegate to UAPs include uncomplicated, non-sterile tasks. UAP can take vital signs on stable clients, and they can assist with activities of daily living, hygiene needs, linen changes, positioning, and other simple tasks. It is not appropriate to delegate vital signs on a client that just returned from a procedure to UAP. The first set of vital signs should be obtained by the registered nurse and continuing assessments can be obtained by the practical nurse. It is also not appropriate to delegate management tasks. Assigning lunch times to staff should be handled by the charge nurse or unit manager.
Test Taking Tip
UAPs can perform many non-invasive and non-sterile tasks. However, they should not be assigned vital signs on a client that may not be stable, and they are not assigned managerial duties.
Video Rationale
Snapshot: This article reviews the scope of practice for different types of nurses and nursing assistants, and tasks that may and may not be delegated to different types of personnel. Delegation is a central feature of contemporary nursing practice, and a key component of professional academic nursing knowledge.
Jump to:
Delegation Overview
- Delegation is the act of transferring responsibility and accountability to another person to carry out a task while maintaining accountability for the action and the outcome.
- RN’s must delegate numerous tasks, and delegation is a core nursing responsibility. Nurses most frequently delegate tasks to LPN’s (Licensed Practical Nurses) and to unlicensed assistive personnel (UAP).
- In deciding when and what to delegate, RN’s must take a number of factors into account, including the scope of practice required for the task, the complexity and predictability of the task, the potential for harm, and level of critical thinking required to perform the task.
- Delegation is important for both practical and academic reasons. It is a core “real world” nursing skill, and it is also a major focus of the NCLEX-RN exam.
RN’s (Registered Nurses)
It is within an RN’s scope of practice to:
- Independently assess, monitor and revise the nursing plan of care for patients of any kind
- Initiate, administer, and titrate both routine and complex medications
- Perform education with patients about the plan of care
- Admit, discharge and refer patients to other providers
- Delegate appropriate tasks to both LVN’s and UAP’s
Tasks that an RN may, therefore, perform include the ability to:
- Initiate and administer blood to a patient
- Administer high risk medications, including heparin and chemotherapeutic agents
- Give IV medications and medications administered via IV push
- Independently monitor and titrate medications
- Perform any tasks that may be performed by LVN’s or UAP’s
LPN’s (Licensed Practical Nurses)
It is within an LPN’s scope of practice to:
- Assist the RN by performing routine tasks with predictable outcomes
- Assist the RN with collecting data and monitoring client findings
- Reinforce an RN’s patient teaching, but not perform independent patient education or assessments
- Perform any of the tasks that UAP’s (Unlicensed Assistive Personnel) are permitted to perform (see below)
- Delegate tasks to UAP’s (Unlicensed Assistive Personnel)
Tasks that an LPN may, therefore, perform include the ability to:
- Administer medications that are not high-risk
- For example, LPN’s may administer standard oral medications, but not medications such as heparin or chemotherapeutic agents
- Note: some states do not permit LVN’s to administer intravenous medications of any kind
- Administer a nasogastric (NG) tube feeding
- Perform wound dressing changes
- Monitor blood products
- LPN’s may not, however, initiate the infusion of blood products; only an RN may initiate the infusion
- Do tracheostomy care
- Perform suctioning
- Check nasogastric tube patency
- Administer enteral feedings
- Insert a urinary catheter
With further education and certification only, LPN’s may administer:
- Maintenance IV fluids
- IV medications via piggy-back
- Monitor infusions of IV fluids
It is not within an LPN’s scope of practice to:
- Administer high risk medications of any kind (such as Heparin and chemotherapeutic medications)
- Administer IV push medications of any kind
- Titrate medications of any kind
- Independently provide patient education (about medications, disease processes, etc.)
- Perform or chart admissions of patients, or to discharge patients
UAP’s (Unlicensed Assistive Personnel)
It is within a UAP’s scope of practice to:
- Assist patients with activities of daily living (ADL’s), including:
- Eating
- Bathing
- Toileting
- Ambulating
- Perform routine procedures that do not
require clinical assessment or critical thinking, such as:
- Phlebotomy (except for arterial punctures)
- Take vital signs
- Monitor intake and output (of food and drink, urine, etc.)
It is not within a UAP’s scope of practice to:
- Perform assessments
- Delegate tasks
- Perform patient education
- Perform tasks that require clinical expertise, including ‘routine’ tasks such as:
- Administering medications
- Administering tube feedings
- Performing wound care or dressing changes