A nurse is developing a care plan for a client who is in Buck’s traction and is scheduled for surgery for a fractured femur of the right leg.
Which of the following interventions should the nurse delegate to an assistive personnel?
A.
Observe the position of the suspended weight.
B.
Check the client’s pedal pulse on the right leg.
C.
Ask the client to describe her pain.
D.
Remind the client to use the incentive spirometer.
The correct answer and Explanation is :
The correct answer is:
D. Remind the client to use the incentive spirometer.
Explanation:
In a healthcare setting, the delegation of tasks to assistive personnel (AP) depends on the complexity and scope of the task, as well as the level of skill required. The tasks listed involve varying degrees of clinical judgment and responsibility.
- Observe the position of the suspended weight (A):
- This task requires careful monitoring of traction equipment to ensure proper alignment and effectiveness. It involves clinical judgment to determine if the equipment is set correctly and is functioning as intended. Therefore, this task should be performed by a registered nurse (RN) rather than delegated to AP.
- Check the client’s pedal pulse on the right leg (B):
- Assessing pedal pulses involves evaluating circulation and potentially identifying complications like impaired blood flow. This is a crucial assessment for a client in Buck’s traction and requires clinical knowledge and skills to interpret the findings and respond appropriately. It should be performed by an RN.
- Ask the client to describe her pain (C):
- Pain assessment requires an RN’s clinical expertise to evaluate pain intensity, quality, and location, and to make decisions about pain management. This assessment helps in forming a care plan and adjusting treatments based on the client’s feedback, which is beyond the scope of AP duties.
- Remind the client to use the incentive spirometer (D):
- Reminding the client to use an incentive spirometer is a straightforward task that involves reinforcing the use of a device to prevent complications such as pneumonia. This task is within the scope of an AP’s role, as it does not require clinical judgment or assessment skills.
By delegating the reminder to use the incentive spirometer to AP, the RN can focus on tasks that require more complex clinical decision-making and assessment.