A 45-year-old male is admitted to the unit with a tentative diagnosis
of liver tumor. He has been experiencing increasing fatigue, anorexia,
and a steady weight loss of 20 pounds over the last few months. He is
currently 6'2'' and weighs 212 pounds. He has moderate jaundice and a
feeling of “fullness” in the mid-epigastric area that radiates to his back.
He states that this fullness never goes away, not even when he hasn’t
eaten for a long time. Current vitals are 102/62, 99.6, 88, and 28. His
lab values are WBC 12,000, K 3.4, protein 4.8, albumin 2.9, AST 130,
ALT 168, and LDH 225.
a. You are the nurse assigned to this patient and you want a measurement of his abdominal girth. You know the signifi cance of this
measurement and ask the NAP to measure the patient’s abdomen.
Was this a good delegation?
b. The patient now has to go for an MRI/CT scan. He needs to be
NPO. The nurse asks the NAP to tell the patient that he is now NPO
for the upcoming tests. Is this a good delegation?
c. The patient’s test results have come back, and lesions were found
on his liver. The physician comes to the unit to biopsy the liver. It is
now a few hours later, and a set of vitals needs to be taken for this
patient. The nurse asks the NAP to get a set of vital signs. Is this a
good delegation?
d. The test results from the biopsy have come back, and the physician has just told the patient that there is nothing that can be
done. The patient has a prognosis of less than six months to live.
The doctor leaves, and the patient is all alone. The nurse asks the
NAP to check to see if the patient is doing alright. Is this a good
delegation?