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Principles of Prioritization & Delegation

The bulk of the NCLEX Examination is about PRIORITIZATION and DELEGATION which I think most of the examinees are weak of. It really needs a compact analysis to get the correct answer.

So here are some basics about Nursing Prioritization and Delegation...


PRIORITY CARE/TRIAGE

Emergent Priority (1st): requires immediate attention and continuous evaluation yet have a high survival rate
  • trauma
  • chest pain
  • severe respiratory deficits
  • chemical splashes to the eyes

Urgent Priority (2nd): injuries non life threatening..treated within 1-2 hours and are evaluated every 30 to 60 minutes thereafter.

  • simple fracture
  • asthma without respiratory distress
  • fever
  • hypertension
  • abdominal pain
  • renal stone

Nonurgent Priority (3rd): clients can wait several hours before being seen and require 1-2 hours of evaluated thereafter.

  • minor laceration
  • sprain
  • cold symptoms

So if someone came in with a chest pain because they ate something wrong and another person that came in with a high blood pressure, do pick the chest pain first.


Delegations

CNAs (Certified Nursing Assistant)
  • skin care, feeding, toileting, vital signs (not initials), height, weight, IOs, ROM exercises, ambulation, transporting, grooming, and hygiene meaures of stable clients.

LPNs/LVNs (Licensed Practical Nurse)

  • physiologically stable clients with predictable outcomes
  • dressings, suctionings, urinary catheterization, med administrations (only oral, subcutaneous, and intramuscular), no rectal or IV meds

RN associated:

  • care for individual in a structured health care environment

RN BSN:
  • care for individuals, families, groups, and communities in both structured and unstructured health settings.
  • RN (all):
  • assessment/planning care, initiating teaching, IV meds

RN can not delegate these tasks:

  • initial assessments of clients
  • evaluation of client data
  • nursing judgement
  • client/family educatoin/evaluation
  • nsg diagnosis
NOTE: Suggested book which is helpful in Prioritization & Delegation problem
Prioritization, Delegation, and Assignment: Practice Exercises for Medical-Surgical Nursing by La Charity
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