A charge nurse is delegating tasks to nursing personnel on a 10-bed medical-surgical nursing unit. Which of the following assignments is an example of overdelegation?

A. While assisting others is an important aspect of nursing care, it generally does not directly reflect the acuity of clients. Assisting colleagues might involve helping with tasks, offering support, or collaborating on care, but it is more related to teamwork and overall unit dynamics rather than directly indicating the complexity or intensity of care needed by individual clients.

B. Medication administration is a significant factor in determining client acuity. The complexity and frequency of medications, the need for monitoring and adjustments, and the administration of high-risk medications (e.g., anticoagulants, insulin) all contribute to the overall acuity level. High acuity clients often require more complex medication management, which demands more time and attention from nursing staff.
C. Meal breaks are a necessary part of a nurse’s schedule but are not related to client acuity. Meal breaks are periods of rest and are essential for maintaining the nurse’s well-being and productivity. However, they do not affect the level of care required by clients or the determination of client acuity.
D. Charting is a crucial component of nursing care that reflects the time spent documenting client information, assessments, and care provided. While charting is essential for legal documentation, communication, and continuity of care, it is not a direct indicator of client acuity.

A. A case manager coordinates and manages the overall care of the client, particularly when there are multiple healthcare needs or transitions in care. Given that the client has just experienced a CVA, the case manager could be crucial in coordinating care, arranging for additional services, and ensuring continuity of care, especially since the client lives alone.
B. The client is experiencing wheezing in the upper lobes of the lungs and is receiving supplemental oxygen. A respiratory therapist would be instrumental in evaluating and managing the client's respiratory status, including optimizing oxygen therapy and addressing any issues related to asthma or lung function.
C. There is no mention of diabetes in the client's history or current symptoms. The focus of the client's care is on managing the effects of the CVA and respiratory issues. Therefore, a referral to a diabetes nurse educator is not indicated based on the provided information.
D. The client has flaccid extremities with decreased muscle tone and strength following the CVA. A physical therapist would be essential for assessing and providing therapy to improve mobility, strength, and function in the affected extremities. This referral is appropriate for addressing the physical impairments resulting from the CVA.
E. The client is having difficulty with self-feeding due to decreased muscle tone and strength, which impacts daily activities. An occupational therapist can help with adaptive techniques and strategies for self-care tasks, such as feeding, and provide interventions to improve the client’s ability to perform daily activities independently. This referral is appropriate for addressing functional challenges related to the CVA.
F. An enterostomal therapy nurse specializes in wound care, ostomy management, and incontinence care. There is no indication in the provided information that the client has any issues related to wounds, ostomies, or incontinence. Therefore, a referral to an enterostomal therapy nurse is not indicated based on the current information.