Which task should be performed by a licensed nurse rather than a UAP for patients with diabetes?

Which task should be performed by a licensed nurse rather than a UAP for patients with diabetes?

• A. Instructing the patient on how to adjust insulin using sliding-scale insulin
• B. Monitoring apical pulse every 4 hours
• C. Reminding the patient to check glucose level before meals
• D. Checking bath water temperature

Answer: (B)

Monitoring the apical pulse every 4 hours is a nursing assessment that requires auscultation, accurate interpretation of rate and rhythm, and the ability to recognize and respond to changes. This kind of ongoing cardiovascular assessment, especially in a patient with diabetes who may have cardiovascular or autonomic issues, is within the licensed nurse’s scope because it informs the plan of care and may prompt immediate action. A UAP handles routine tasks and basic data collection, but not assessments that require clinical judgment or interpretation of results. In contrast, instructing a patient on how to adjust insulin using sliding-scale dosing involves pharmacologic knowledge and patient teaching about medication safety, which requires a licensed nurse. Reminding the patient to check glucose before meals is a cueing task that can be delegated after appropriate direction, and checking bath water temperature is a safety task also commonly delegated to UAPs. So, the task that truly requires a licensed nurse is the regular apical pulse assessment and interpretation.

Monitoring the apical pulse every 4 hours is a nursing assessment that requires auscultation, accurate interpretation of rate and rhythm, and the ability to recognize and respond to changes. This kind of ongoing cardiovascular assessment, especially in a patient with diabetes who may have cardiovascular or autonomic issues, is within the licensed nurse’s scope because it informs the plan of care and may prompt immediate action. A UAP handles routine tasks and basic data collection, but not assessments that require clinical judgment or interpretation of results.

In contrast, instructing a patient on how to adjust insulin using sliding-scale dosing involves pharmacologic knowledge and patient teaching about medication safety, which requires a licensed nurse. Reminding the patient to check glucose before meals is a cueing task that can be delegated after appropriate direction, and checking bath water temperature is a safety task also commonly delegated to UAPs.

So, the task that truly requires a licensed nurse is the regular apical pulse assessment and interpretation.