Which statement made by an RN regarding delegation indicates the need for additional teaching? (Select all that apply.)
a. Unlicensed assistive personnel (UAP) can assess vital signs during the first 5 minutes for a patient who is receiving a blood transfusion because a reaction at this time is unlikely.
b. An LPN/LVN can administer a PPD (tuberculin skin test) if there is no history of a positive PPD.
c. When dopamine is ordered continuously, the LPN/LVN can administer dopamine at a low dose for the purpose of increasing renal perfusion.
d. UAPs can transfer a patient who is being discharged home from the wheelchair to the bed if they have received training and demonstrated competency.
e. Responsibility can be delegated to the UAP, but the delegator retains accountability.
ANS: A, B, C
Correct:
a. The statement "UAPs can assess vital signs during the first 5 minutes for a patient who is receiving a blood transfusion because a reaction at this time is unlikely" indicates the need for further teaching because the patient is at highest risk of a reaction during the first few minutes of a blood transfusion; thus the assessment skills of an RN are required.
b. The statement "an LPN/LVN can administer a PPD (tuberculin skin test) if there is no history of a positive PPD" indicates the need for further teaching because administration of intradermal medication requires the skill of an RN.
c. Dopamine is a vasoactive drug that can have a profound effect on a patient's blood pressure and cardiac output; administration requires the assessment and evaluation skills of an RN.
Incorrect:
d. The RN can delegate this responsibility if the patient is stable and the competence of the UAP has been established.
e. Accountability remains with the person who is delegating, but when the UAP accepts the assignment, responsibility rests with the UAP.
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