A client with iatrogenic Cushing's syndrome is a resident in a long-term care facility. Which nursing action included in the client's care would be best to delegate to unlicensed assistive personnel (UAP)?

• A. Assist with personal hygiene and skin care.
• B. Develop a plan of care to minimize risk for infection.
• C. Instruct the client on the reasons to avoid overeating.
• D. Monitor for signs and symptoms of fluid retention.

Answer: (A)

The key idea here is matching tasks to what unlicensed assistive personnel can safely handle, while considering how the condition affects the patient’s care needs. Iatrogenic Cushing’s syndrome causes skin that is thin and easily injured, with edema that can make skin care more delicate. Routine personal hygiene and skin care—bathing, grooming, moisturizing, maintaining clean skin folds, and reporting any skin changes—is a basic, non-judgmental ADLs task that UAP are trained to perform. Delegating this kind of care helps protect the patient from skin breakdown and maintains comfort, while freeing licensed staff to handle assessment and planning.

Tasks that involve nursing judgment or education—such as developing a plan of care to minimize infection risk, teaching the patient why overeating should be avoided, or continuously monitoring for fluid retention—require licensed personnel. Those duties involve assessment, interpretation of findings, and providing information or interventions beyond routine tasks, so they aren’t appropriate for delegation to UAP.