A client is admitted with a lower urinary tract infection from an obstructing ureteral stone. Which tasks can the registered nurse (RN) delegate to the experienced unlicensed assistive personnel (UAP)? Select all that apply.

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11ecbb05_cb87_5fe1_b433_e7b70be30446_MD0009_00 Measuring intake and output and obtaining a urine specimen for culture and sensitivity are both appropriate duties to delegate to the UAP. Objective measurements (eg, vital signs, intake and output) do not require assessment skills and are therefore appropriate for delegation (Option D). Nursing actions that require assessment, teaching, evaluation, or clinical judgment must be performed by the RN. Collecting a urine specimen is a routine task with a predictable outcome and is therefore appropriate for delegation to the experienced UAP under the instruction and supervision of the RN (Option B). The RN should always observe the five rights of delegation by verifying that the UAP have the skills and experience necessary to collect a urine specimen without contamination. If this client had a Foley catheter, specimen collection would be inappropriate for delegation to the UAP. Collecting a specimen from a Foley catheter is considered a sterile procedure as it involves accessing a sterile collection port and risks introducing bacteria into the closed drainage system if done improperly. However, when provided with the appropriate instructions, the UAP and even clients themselves may collect a clean-catch or midstream urine specimen. (Option A) Conducting a review of the client's complete past medical history is an important responsibility of the RN during the admission assessment. This requires skills and understanding beyond the level of the UAP. (Option C) Client education about the procedure and rationale for straining urine is the responsibility of the RN. After the RN assesses the knowledge and competency level of the UAP, the UAP can gather supplies, remind the client to strain the urine, and report any abnormal findings to the RN for assessment and validation. (Option E) Monitoring the color and characteristics of urine output is a qualitative assessment that should be performed by the RN. Educational objective: Collection of routine specimens and measurement of intake and output are appropriate duties for the UAP. Nursing actions that require assessment, teaching, evaluation, or clinical judgment must be performed by the RN.

A Client Is Admitted with a Lower Urinary Tract Infection