The nurse is caring for a client with dyspnea. Which interventions can the nurse delegate to an unlicensed assistive personnel (UAP)?

Select all that apply.
  1. assessing lung sounds
  2. checking a pulse oximetry
  3. administering oxygen via nasal cannula
  4. encouraging the client to cough and deep breathe
  5. showing the client how to use an incentive spirometer
Numbers 2 and 4 are correct.
Rationale: A UAP can obtain a pulse oximeter reading on a client once he has demonstrated competency in using the device, which clips onto the finger similar to a clothespin. In many facilities, this is part of taking routine vital signs. The UAP can also prompt the client to do coughing and deep breathing once the nurse has shown the client how to perform it; however, the nurse must be the one to initially educate the client on the technique. UAPs cannot teach or assess clients; this is an activity reserved for the nurse. Only the nurse can assess lung sounds. Administering oxygen must be done only by the nurse. If the client is already on nasal cannula and gets up to use the restroom, the UAP may assist the client back to bed and place the nasal cannula back on the client once the UAP has demonstrated the proper technique. In no instance may the UAP be the one to initiate oxygen therapy, nor may he adjust the flow rate. The nurse should educate the client on incentive spirometer use. Depending on the facility, the nurse or respiratory therapist should assess and chart the client’s number of attempts, the highest reading obtained, and gauge the work of breathing on a scale.