Which actions could the nurse safely delegate to the unlicensed assistive personnel (UAP)?
1. Assist the client to use the bedpan for bowel elimination.
2. Change the ostomy appliance for the new ostomy.
3. Administer a cleansing enema.
4. Remove a fecal impaction.
5. Determine effectiveness of cleansing enema.
1, 3
Rationale 1: The UAP can be entrusted with assisting the client to use a bedpan.
Rationale 2: Only the nurse can change a new ostomy appliance, because of the need to assess the drainage and the site.
Rationale 3: The UAP can administer most types of enemas.
Rationale 4: Because of the risk of vagal nerve stimulation, the nurse should remove fecal impactions.
Rationale 5: Assessing the effectiveness of any treatment should be performed by the nurse.
Global Rationale: The UAP can be entrusted with assisting the client to use a bedpan, and can administer most types of enemas. However, only the nurse can change a new ostomy appliance, because of the need to assess the drainage and the site. Because of the risk of vagal nerve stimulation, the nurse should remove fecal impactions. Assessing the effectiveness of any treatment should be performed by the nurse.
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