Nursing Prioritization Delegation Assignment Q 22
You are initiating a nursing care plan for a patient with pneumonia. Which intervention for cough enhancement should you delegate to a nursing assistant?
A. Teaching the patient about the importance of adequate fluid intake and hydration.
B. Assisting the patient to a sitting position with neck flexed, shoulders relaxed, and knees flexed.
C. Reminding the patient to use an incentive spirometer every 1 to 2 hours while awake.
D. Encouraging the patient to take a deep breath, hold it for 2 seconds, then cough two or three times in succession.
Correct Answer: C. Reminding the patient to use an incentive spirometer every 1 to 2 hours while awake
A nursing assistant can remind the patient to perform actions that are already part of the plan of care. The right person must be assigned to the right tasks and jobs under the right circumstances. The nurse who assigns the tasks and jobs must then communicate with and direct the person doing the task or job. The nurse supervises the person and determines whether or not the job was done in the correct, appropriate, safe and competent manner.
Option A: Teaching patients about adequate fluid intake requires additional education and skill and is within the scope of practice of the RN. Among the tasks that cannot be legally and appropriately delegated to nonprofessional, unlicensed assistive nursing personnel, such as nursing assistants, patient care technicians, and personal care aides, include assessments, nursing diagnosis, establishing expected outcomes, evaluating care and any and all other tasks and aspects of care including but not limited to those that entail sterile technique, critical thinking, professional judgment and professional knowledge.
Option B: Assisting the patient in the best position to facilitate coughing requires specialized knowledge and understanding that is beyond the scope of practice of the basic nursing assistant. However, an experienced nursing assistant could assist the patient with positioning after the nursing assistant and the patient had been taught the proper technique. The nursing assistant would still be under the supervision of the RN.
Option D: Discussing and teaching require additional education and training. These actions are within the scope of practice of the RN. The client is the center of care. The needs of the client must be competently met with the knowledge, skills and abilities of the staff to meet these needs.