NCLEX Review

Nursing NCLEX RN Review Video: Delegation of Tasks

https://youtu.be/xNU0KAf2lG8

Nursing NCLEX RN Review Video: Delegation of Tasks

 

In this video I am going to talk about the delegation of tasks needed to know for the nursing NCLEX RN exam.  Before I begin, be sure to check out the links in the description box for various free NCLEX content and subscribe as I upload at least one new nursing video every single week.

 

The NCLEX exam will test you on your role in relation to other health care professionals. It is important to know when to contact a provider, when to utilize UAP’s or care aides or nursing assistants etc.. Therefore this is an incredibly high yielding portion of the NCLEX exam that you need to practice heavily. It is common to get a question like this on your exam so be prepared. Try not to use your personal experience with these other disciplines in the hospital as it seems to vary greatly from hospital to hospital-instead use these general guidelines.

 

Now you might be asking what is the best way to approach these questions and what I can tell you is a list of tasks that UAP and LPN are NOT supposed to do. If you think about it in this way it becomes easier to know for sure what to not select on a SATA question. This is one of those skills that as you do more questions you become familiarized with a theme of what a discipline can or cannot do.

 

Let’s start off by talking about Unlicensed assistive personnel or UAP’s. UAP’s are NOT allowed to:

  • Feed clients with potential dysphagia or make evaluations about treatment effectiveness.
  • Perform INITIAL teaching, education and assessment. Emphasis on initial as they will use this to trick you.

 

Now let’s talk about what UAP’s can do:

  • They can perform passive range-of-motion exercises.
  • They can apply protective ointment
  • They can obtain objective data for stable clients under the direction of a registered nurse. Here is a list of objective data UAP’s can perform:
    • UAP’s can perform technical skills such as capillary blood glucose monitoring and IV catheter removal with appropriate training.
    • They can obtain routine, stable vital signs
    • They can document input/output
    • They can obtain patient’s weight
  • They can help with activities of daily living, Hygiene, change linens and help place patients in positions.

 

Before I continue talking about LPN’s, these videos take a long time to make and if you would like to see more videos like this give me feedback by either giving it a thumbs up or thumbs down. This will help me decide whether I should continue making more videos like this. Thank you.

 

LPN Duties include:

  • Monitoring RN findings
  • Reinforcing education
  • Routine procedures (think of catheterization)
  • Most medication administrations
  • Ostomy care
  • Tube patency & enteral feeding
  • Specific assessments*

 

LPN’s are NOT allowed to do:

  • Initial assessment, teaching and education

 

RN Duties include:

  • Clinical assessments
  • Initial client education
  • Discharge education
  • Clinical judgment
  • Initiating blood transfusion
  • Teaching

 

Other important facts about delegation:

 Although these tasks could be performed safely by an LPN, underutilizing UAP would be an ineffective use of resources. Therefore if a situation has UAP and LPN make sure UAP does what an UAP can do and a LPN does what a LPN can do. Basically try to be effective in utilizing both UAP’s and LPN’s.

  • For example, routine activities of daily living (eg, positioning) are generally suitable to be delegated to unlicensed assistive personnel (UAP).  Obtaining the client’s weight may be delegated to UAP. However ostomy care and routine procedures such as catheterizations can be given to a LPN.

 

 

Lastly for this section I think it also important to quickly talk about triage. Patients that require triaging is one of the many roles of a registered nurse. Being able to triage patients based on the type of injury suffered from natural disasters in particular is what the NCLEX requires you to know. It can come up on the NCLEX and therefore it is important for you to have a general idea of what to do in these cases. I will try and simplify it so that it becomes easy to understand and apply.

 

Emergent: Red Shock

Compromised airway

Unstable wounds (uncontrolled bleeding)

Chest trauma (tension pneumothorax)

Myocardial Infarctions

Strokes

Urgent: Yellow Fractures WITH pulses

Large wounds

Nonurgent: Green Infections

Minor cuts scrapes or burns

Closed fractures

Expectant (not adequate for life): Black Pulseless

No breathing effort

Neurological trauma (spinal cord injury etc..)

Large burns (>65% of total body surface area)

 

Pay particular attention to compromised airways in red and fractures that could land in yellow or green. Some examples of compromised airway are severely altered levels of consciousness or adventitious noises that could be presented as stridor. Remember that an open fracture, the bone pokes through the skin and can be seen or a deep wound exposes the bone through the skin. Closed fracture however is where The bone is broken, but the skin is intact.

 

Think of red as a high probability of a positive outcome if the patient receives medical interventions quickly. Yellow as treatment required but can wait for an hour. Green as injuries that require treatment but can wait greater than two hours. Black has a very low chance of survival with medical treatment.

 

That is going to be the end of this video. Here is how to get to my website simplefitnurse.com for free NCLEX content. Thank you for watching and in my next NCLEX video we are going to be talking about isolation precautions for the nursing NCLEX RN exam.

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