Question

The nurse has received a client from the emergency room with a fractured right hip. Which task should the nurse assign to the unlicensed assistive personnel (UAP)? A. Obtain personal care items and place at bedside B. Assess the skin for any signs of breakdown C. Administer meperidine (Demerol) \(75 \mathrm{mg}\) IM D. Apply Buck's traction \(5 \\#\) to right leg

Short answer

Answer: Obtain personal care items and place at bedside.

Step-by-step solution

Analyzing Option A

Obtain personal care items and place at bedside. This task involves obtaining personal items and organizing them at the bedside for the client. This is a basic task that does not require a nursing license and is something that UAPs can perform.

Analyzing Option B

Assess the skin for any signs of breakdown. This task involves observing the client's skin for any signs of compromise, such as redness, swelling, or open areas. This is a task that requires clinical judgement and nursing assessment skills, which are beyond the scope of a UAP's role.

Analyzing Option C

Administer meperidine (Demerol) \(75 \mathrm{mg}\) IM. This task involves administering a medication, specifically an opioid analgesic, to the client through an intramuscular injection. This is a task that requires a nursing license as it involves both medication administration and a specific method of injection.

Analyzing Option D

Apply Buck's traction \(5 \mathrm{lb}\) to the right leg. This task involves applying a specific type of traction to the client's affected leg. This is a task that requires clinical judgement and nursing assessment skills, as well as specific knowledge about the proper technique for applying traction, which are beyond the scope of a UAP's role.

Conclusion

Based on the analysis of each option, the task the nurse should assign to the unlicensed assistive personnel (UAP) is Option A: Obtain personal care items and place at bedside, as it is a basic task that does not require a nursing license and is within the UAP's scope of practice.

Key concepts

Nurse Delegation

Nurse delegation is a critical skill in the nursing profession, especially when ensuring the effective management of patient care. This involves the nurse's ability to delegate responsibilities to unlicensed assistive personnel (UAP) appropriately.

When delegating, nurses must consider the task's complexity, the patient's condition, the UAP's competence, and the context of the care situation. The goal is to maximize efficiency without compromising patient safety.

Criteria for Delegation

The American Nurses Association outlines five key rights of delegation to promote safe practice:

• The right task
• The right circumstances
• The right person
• The right directions and communication
• The right supervision and evaluation

Selecting the appropriate task for delegation involves tasks that do not require the nurse's professional judgment, such as obtaining personal care items (Option A in the exercise). This task is ideal for delegation because it aligns with the UAP's abilities and allows the nurse to focus on more complex care needs.

UAP Scope of Practice

Understanding the UAP scope of practice is essential for safe and effective delegation. The scope of practice for unlicensed assistive personnel varies depending on the state's regulations and facility policies, but typically includes non-invasive and routine tasks.

Tasks within the UAP scope often consist of basic patient care activities, support tasks, and some clerical duties associated with patient care. UAPs might assist with bathing, feeding, and ambulating patients, as well as measuring vital signs under the supervision of a nurse.

Limitations of UAPs

Tasks that require nursing assessments, clinical judgments, or specialized nursing skills, such as skin assessments (Option B) and applying B1uck's traction (Option D), are beyond the UAP's scope. In the exercise provided, Option A aligns with the UAP’s scope of practice, ensuring both effective care and adherence to regulatory standards.

Nursing Assessment

Nursing assessment is a comprehensive evaluation conducted by a licensed nurse to determine a patient's health status. It is a fundamental aspect of the nursing process, providing the foundation for diagnosis, planning, intervention, and evaluation of care.

This process involves collecting both subjective and objective data, such as patient history, physical examination findings, and diagnostic test results. The nurse integrates this information to identify patient needs and health problems.

Comprehensive Assessment

A thorough nursing assessment requires a high level of skill and knowledge. Nurses assess skin integrity (Option B), monitor for signs of infection or complications, and evaluate the effectiveness of medical devices, such as traction (Option D). These activities are beyond a UAP's role, as they demand professional nursing judgment.

Medication Administration

Medication administration is an integral part of a nurse's responsibilities and involves multiple steps to ensure patient safety. These steps include verifying patient identity, confirming the medication order, assessing the patient's condition for contraindications, administering the medication correctly, and monitoring the patient post-administration.

Medication administration requires a deep understanding of pharmacology, dosage calculation, side effects, and drug interactions. It is exclusively within the purview of licensed healthcare professionals.

Critical Aspects of Medication Administration

Significant attention to detail is needed when administering medications, especially controlled substances like meperidine (Demerol) (Option C). Only nurses and other licensed professionals are authorized to perform such tasks, given their potential risks and the complexity involved in the administration process.