Clarification on UAP for NCLEX

[belljar1995, PhD, RN]

HI everyone,

I've been studying for my test which is next month and using Hurst, Uworld and Lacharity. In my Hurst review, we identified the roles of the UAP and LPN and we were told that neither should take vital signs on an unstable patient--that the RN wants to do this. OK--fine--no problem. However, when I am working in the Lacharity book in almost all cases, even with ER patients, ICU etc---the vital signs are done by the UAP (as well as a few other tasks). So now I 'm a bit unsure of how to approach things for the big day. How have others reconciled some of the conflicting information, rationales, explanations among sources? What did you finally decide in terms of how you would address issues? or..am I just making a big deal over nothing ?

[NICU Guy, BSN, RN]

Not all ER and ICU patients are unstable. For example, a healthy 18 yr old comes to the ER with a broken ankle from playing basketball. Would you delegate a UAP to take his vitals. Yes, he is stable. 75 yr old comes to the ER with an active MI. Would you delegate a UAP to take vitals? No, the patient is highly unstable.

[belljar1995, PhD, RN]

Yes, definitely that I understand. But if you look in the lacharity book case studies--they are all acute --for example--woman comes into ER with crushing chest pain and SOB.... (and the UAP answers are taking vitals)---UAP is also able to take vitals immediately before blood product transfusion--whereas...according to my experiences---the nurse always took the vitals right before, 15 minutes into transfusion and then the last (post transfusion) vitals. Anyone in the ICU---tends to be unstable So, this is why I am confused--there are lots of unstable cases in Lacharity. Obviously someone in the ER with a sprain...can have vitals done by a UAP.