The nurse and unlicensed assistive personnel (UAP) on the telemetry unit are caring for four clients. Which nursing action can be delegated to the UAP?
A.
Checking the client’s catheter site after a coronary angiogram
B.
Teaching a patient about exercise electrocardiography
C.
Attaching ECG monitoring electrodes after a patient bathes
D.
Monitoring a client after a transesophageal echocardiogram
The Correct Answer and Explanation is:
The correct answer is C. Attaching ECG monitoring electrodes after a patient bathes.
Explanation:
In the context of delegating tasks to unlicensed assistive personnel (UAP), it’s crucial to understand the scope of practice for both RNs and UAPs to ensure patient safety and compliance with legal and ethical standards. Here’s a breakdown of why option C is appropriate for delegation, while the other options are not:
- Attaching ECG monitoring electrodes after a patient bathes (Option C):
- Scope of UAP Practice: UAPs are trained to perform specific tasks that do not require nursing judgment or assessment. Attaching ECG monitoring electrodes falls into this category, as it involves a routine task that UAPs can perform after the patient has bathed. This task is mechanical and does not require critical thinking or assessment skills.
- Reason for Delegation: This task is straightforward and does not involve any assessment of the patient’s condition or require interpretation of results. It can be safely delegated to a UAP under the supervision of a registered nurse (RN).
- Checking the client’s catheter site after a coronary angiogram (Option A):
- Scope of RN Practice: Checking the catheter site after a procedure like a coronary angiogram involves assessing for complications, such as bleeding or infection. This requires clinical judgment, knowledge of potential complications, and the ability to interpret findings. Therefore, this task must be performed by an RN, not a UAP.
- Teaching a patient about exercise electrocardiography (Option B):
- Scope of RN Practice: Patient education about procedures, including exercise electrocardiography, requires a deep understanding of the procedure, its purpose, and its implications. This type of teaching involves clinical knowledge and the ability to answer patient questions and provide detailed explanations. Hence, this task is beyond the UAP’s scope and must be performed by an RN.
- Monitoring a client after a transesophageal echocardiogram (Option D):
- Scope of RN Practice: Monitoring a patient after a transesophageal echocardiogram involves assessing the patient for post-procedure complications and ensuring their safety. This requires specialized knowledge and clinical judgment, which are within the RN’s scope of practice but not that of a UAP.
In summary, delegation is appropriate when the task does not require advanced clinical judgment or assessment skills. Attaching ECG electrodes is a routine, technical task that UAPs are trained to perform, making it suitable for delegation.