NCLEX-RNManagement of CareHard
A charge nurse is delegating blood glucose monitoring to a UAP for four clients. Which client's blood glucose check is inappropriate to delegate to the UAP?
- AA stable client with type 2 diabetes on routine oral medications
- BA client with well-controlled gestational diabetes performing routine home glucose checks
- CA client newly diagnosed with diabetic ketoacidosis who is on an insulin drip and requires frequent glucose trending with clinical correlation
- DA postoperative client with type 1 diabetes on a stable sliding-scale insulin regimen
Show answer & explanationAnswer & explanation
Correct answer: C. A client newly diagnosed with diabetic ketoacidosis who is on an insulin drip and requires frequent glucose trending with clinical correlation
UAPs can perform routine, stable blood glucose checks, but clients requiring clinical judgment, trending analysis, and correlation with changing insulin drip rates in an unstable condition like DKA require RN assessment and are not appropriate for delegation.
Why the other options are wrong
- A. This is a stable, routine task appropriate for UAP delegation.
- B. Well-controlled gestational diabetes with routine checks is a stable task appropriate for delegation.
- D. A stable postoperative client on a set sliding scale is appropriate for UAP glucose checks.
Delegation & Clinical Judgment
Tasks requiring clinical judgment, assessment, or correlation with unstable conditions cannot be delegated to UAP, even if the task itself (like glucose checks) is routine.
- UAPs can perform data collection on stable clients
- RNs must retain tasks requiring assessment or judgment
- Unstable clients (e.g., DKA, insulin drips) need RN oversight
- The five rights of delegation include right task and right circumstance
Memory trick: Stable checks to UAP, unstable stays with RN's cap.