Prioritization and Delegation

Question 1

prioritization questions have what 4 parts? whats irrelevant? most imp?

Answer 1

• age & gender –> irrelevant
• diagnosis –> important
• modifying sentence –> most important

Question 2

what are 3 rules for prioritization

Answer 2

1) acute > chronic
2) fresh post-op (<12 hr) > medical or other surgical
3) unstable > stable

Question 3

what words in a prioritization question indicate the pt is stable

Answer 3

• “stable”
• chronic illness
• post op >12h
• local or regional anesthesia
• lab abnormal of A or B lvl
• “ready for d/c”, “to be d/c”
• admitted >24 h ago
• unchanged assessment
• experiencing the typical, expected S&S

Question 4

what things in a question indicate the pt is unstable

Answer 4

• “unstable”
• acute illness
• postop <12 h
• GA in first 12h
• C or D lvl abnormal labs
• changed assessments
• experiencing unexpected S&S

Question 5

what 4 things are always unstable regardless of it’s expected?

Answer 5

1) hemorrhage
2) fever >105 (risk of seizure, 40*C)
3) decreased BG
4) pulseless or breathless

Question 6

if you need a tie breaker between two answers in a prioritization question, what do you do?

Answer 6

• more vital organ (in modifying = highest priority
  1) brain
  2) lung
  3) heart
  4) liver
  5) kidney
  6) pancreas

Question 7

what can you NOT delegate to a LPN

Answer 7

• starting an IV
• hanging or mixing IV meds
• IV push
• no central lines
• no blood admin
• cannot plan care
• cannot do the first of anything
• no admission, d/c, or transfer
• cannot do the first assessment after a change

Question 8

what can you NOT delegate to UAPs

Answer 8

• charting (can chart what they did but not about the pt)
• no meds except topical OTC barrier creams
• no assessments except VS or BG
• no treatments except enemas and catheterization

Question 9

what can UAPS do?

Answer 9

• ADLs

Question 10

what can you not delegate to family members

Answer 10

• safety responsibilities

Question 11

what are the 4 common answer choices with staff management when there is inappropriate staff behavior

Answer 11

1) tell supervisor
2) confront & take over
3) talk about it a later date
4) ignore it

Question 12

what thought process should you go through when answering a question about inappropriate staff behavior

Answer 12

1) is it illegal? if yes, tell supervisor. if no, ask:
2) is anyone in immediate physical or psychological harm? if yes, confront & take over. if no, ask:
3) is it legal, no harmful, but simply inappropriate? if yes, deal with later