The nurse is working with a newly hired unlicensed assistive personnel (UAP). Several activities of daily living need to be completed for the nurse’s clients. Which task should the nurse delegate to the UAP?

  1. performing oral care on a client with a bleeding disorder
  2. turning a client with a tibial fracture with external fixation
  3. assisting a client admitted with COPD exacerbation to the chair
  4. reinforcing teaching on use of the inhaler for a client with asthma
Number 3 is correct.
Rationale: The client with COPD exacerbation who can get up to the chair is the best choice for the UAP. Sitting upright in the bed or a chair allows for maximum ease of breathing and is the best position for coughing and clearing secretions. The nurse should perform oral care on clients with bleeding disorders due to the increased risk of bleeding. The client with a tibial fracture and external fixation must be positioned and turned in a specific manner so as to maintain fixation. Turning clients with special turning requirements should not be delegated to inexperienced personnel. The nurse must verify that the UAP is properly trained in turning these clients. Reinforcement of teaching is still considered teaching and may only be done by the licensed nurse. The nurse is responsible for all tasks that are delegated and must ensure that they are performed safely.