A nurse is making assignments for staff on an inpatient unit. Which of the following tasks can a nurse legally delegate to assistive personnel?

Choice A reason: Explaining the implications of a Do Not Resuscitate (DNR) status ensures the client understands that no CPR or intubation will occur if their condition deteriorates. This supports informed consent and autonomy, clarifying the scope of DNR to prevent misunderstandings. It respects the client’s decision-making capacity, ensuring their wishes align with end-of-life care preferences.
Choice B reason: Placing a “Do Not Resuscitate” sign outside the room breaches confidentiality under HIPAA, risking unauthorized disclosure of sensitive information. DNR status is communicated via medical records or wristbands. This action is inappropriate, as it does not contribute to implementing the client’s wishes and violates privacy standards, making it an incorrect response.
Choice C reason: Obtaining family consent is unnecessary for a competent client’s DNR request, as autonomy rests with the client. If decisionally capable, their wishes override family input. The nurse’s role is to support the client’s decision, not seek family approval, unless the client is incapacitated, which is not indicated, making this action inappropriate.
Choice D reason: Documenting the DNR request in the medical record ensures the care team follows the client’s wishes, preventing unwanted interventions. Accurate documentation communicates code status, supports legal and ethical standards, and ensures continuity of care. This is critical for aligning treatment with the client’s end-of-life preferences, making it a necessary action.

Choice A reason: Checking patency every 8 hours is inadequate for closed wound drainage systems, which require more frequent monitoring (e.g., every 4 hours) to detect blockages. Delayed checks risk fluid buildup, increasing infection or seroma risk, critical in postoperative wound management.
Choice B reason: Emptying the drainage system every 24 hours may be insufficient, as frequency depends on volume. Systems like Jackson-Pratt drains need emptying when half-full to maintain suction, preventing complications like infection, requiring flexible, volume-based schedules rather than fixed intervals.
Choice C reason: Securing the drainage system to the gown prevents dislodgement, maintaining suction and reducing infection risk. It supports mobility while stabilizing the system, preventing wound tension. This is critical for effective drainage and healing in postoperative clients with closed systems.
Choice D reason: Replacing the drainage system every 3 days is unnecessary unless infection or malfunction occurs. Routine replacement risks introducing pathogens or disrupting healing. Systems remain until drainage decreases, guided by clinical assessment, not a fixed schedule, to ensure safety.