The nurse caring for several clients could safely delegate which task to unlicensed assistive personnel (UAP)?
1. Initial application of the continuous positive motion (CPM) device to the postoperative client
2. Assessment of client's tolerance for passive range of motion
3. Documentation of joint improvement resulting from active range of motion
4. Performance of passive range of motion to client experiencing a CVA 2 weeks ago
4
Rationale 1: Initial application of the CPM must be performed by the nurse.
Rationale 2: Assessing a client's tolerance for passive range of motion must be performed by the nurse.
Rationale 3: Assessing a client's progress must be performed by the nurse.
Rationale 4: The UAP can safely perform passive range of motion on a stable client if educated in the skill.
Global Rationale: The UAP can safely perform passive range of motion on a stable client if educated in the skill. Initial application of the CPM, and assessing a client's tolerance or progress, must be performed by the nurse.
You might also like to view...
The nurse notes fanning of the toes when the sole of the foot is stimulated during assessment of the plantar reflex. Which is appropriate for the nurse to use when documenting this finding in the medical record?
1. Hyperreflexia. 2. Babinski response. 3. Brudzinski sign. 4. Nuchal rigidity.
The nurse providing care for a patient post percutaneous transluminal coronary angioplasty (PTCA) knows to monitor the patient closely. What does the nurse know to monitor for?
Select all that apply. A) Abrupt closure of the coronary artery B) Venous insufficiency C) Bleeding at the insertion site D) Retroperitoneal bleeding E) Arterial occlusion
The nurse is conducting a staff in-service on sickle cell anemia. Which describes the pathologic changes of sickle cell anemia?
a. Sickle-shaped cells carry excess oxygen. b. Sickle-shaped cells decrease blood viscosity. c. Increased red blood cell destruction occurs. d. Decreased adhesion of sickle-shaped cells occurs.
The nurse has just completed wound care on her patient who has a large abdominal wound. What should the nurse do soon after this is completed? Select all that apply
a. Assess the patient's response to the procedure b. Teach the patient about the procedure c. Document the procedure in the nursing progress notes d. Ask the patient to assist in the wound care at the next scheduled dressing change