A nurse on a medical-surgical unit is preparing to assign vital sign measurements for a group of clients. Which of the following clients should the nurse delegate to an assistive personnel?

Rationale:

A. Inserting a nasogastric (NG) tube is an invasive procedure that requires knowledge of anatomy, patient assessment, and potential complications. It involves clinical judgment and skill; therefore, it cannot be delegated to an assistive personnel (AP). Only licensed nurses with the necessary competency should perform this task.

B. Performing a simple dressing change is considered a routine, non-invasive task that follows established protocols and does not require independent nursing judgment. An AP can safely remove and replace clean dressings or assist with basic wound care, allowing the nurse to focus on more complex care, assessments, or procedures that require critical thinking.

C. Providing advice to a client over the telephone involves assessing symptoms, prioritizing care, and making clinical decisions. This is within the scope of practice of a registered nurse, as it requires professional judgment, and cannot be delegated to an AP. Providing advice incorrectly could lead to harm.

D. Teaching a client how to walk on crutches is an educational intervention that requires the nurse to assess the client’s physical ability, balance, and coordination. The nurse also ensures safety and correct technique. This task cannot be delegated to an AP, as it requires assessment, instruction, and judgment.

Rationale:

A. Scheduling the consultation when the primary nurse can attend ensures effective communication between the care team and the wound care specialist. The nurse can provide accurate, up-to-date information about the client’s condition, treatments, and response to care, which supports continuity and quality of care.

B. Arranging for daily visits by the wound care specialist is not necessary in most cases and could be resource-intensive. Frequency of consultation should be based on the client’s clinical needs rather than a fixed schedule.

C. Providing subjective opinions or beliefs is inappropriate. Consultants require objective, factual information about the client’s condition, such as wound measurements, appearance, and treatment response, to make informed recommendations.

D. Delaying the consultation until after several treatments are tried can risk worsening the pressure injury. Early involvement of a wound care specialist is recommended to promote healing, prevent complications, and optimize outcomes.