護理師正在為一位有高血壓病史的病人進行入院評估。在指派任務給助理護理員 (UAP) 時，哪項動作是優先的？

護理師在執行醫療任務時，必須確保病人安全，並妥善運用醫療團隊資源。其中，善用輔助性醫療人員（如助理護理員 UAP, Unlicensed Assistive Personnel）是提升照護效率與品質的關鍵。然而，指派任務時，必須嚴格遵守各職類的工作範圍（Scope of Practice）。 高血壓（Hypertension）病史的病人，其入院評估和後續照護需要專業護理師的判斷。助理護理員（UAP）的工作職責主要在於執行基礎的照護任務，如測量生命徵象、協助病人移動、維持環境整潔等。 正確答案 D，指示 UAP 測量並記錄病人的生命徵象（Instructing the UAP to measure and record the client's vital signs），是最優先且適當的指派任務。測量生命徵象（體溫、脈搏、呼吸、血壓、疼痛評估）是 UAP 的標準工作範圍，即使病人有高血壓病史，其生命徵象的測量本身仍屬於基礎護理範疇。 錯誤選項分析： B. 指派 UAP 更新病人服藥記錄卡（Assigning the UAP to update the client's medication administration record）：服藥記錄卡的更新涉及藥物管理、核對及記錄，屬於護理師的專業職責，UAP 無權執行。 C. 要求 UAP 解釋病人實驗室結果（Asking the UAP to interpret the client's lab results）：實驗室結果的判讀與臨床意義分析，需要專業的醫學知識與臨床判斷，絕對是護理師或醫師的職責，UAP 絕不可執行。 D. 讓 UAP 執行初次護理評估（Having the UAP perform the initial nursing assessment）：初次護理評估（Initial nursing assessment）是護理過程的基礎，包含收集主客觀資料、識別病人問題、建立護理診斷等，是護理師的核心專業職責，絕對不可委派給 UAP。 在臨床實務中，護理師應根據病人的病情穩定性、任務的複雜性以及 UAP 的能力來決定任務的指派。對於有高血壓病史的病人，雖然需要額外的關注，但基礎的生命徵象監測仍然可以安全地委派給 UAP，護理師則負責進一步的評估、分析與決策。

When performing medical tasks, the nurse must ensure patient safety and make appropriate use of healthcare team resources. Effectively utilizing assistive personnel, such as the unlicensed assistive personnel (UAP), is key to improving care efficiency and quality. However, in delegating tasks, the nurse must strictly adhere to the scope of practice of each role. For a client with a history of hypertension, admission assessment and ongoing care require the judgment of a registered nurse. The UAP's responsibilities focus on basic care tasks such as measuring vital signs, assisting with client mobility, and maintaining a clean environment. The correct answer, D—instructing the UAP to measure and record the client's vital signs—is the most appropriate task to delegate. Measuring vital signs (temperature, pulse, respirations, blood pressure, and pain assessment) falls within the standard scope of practice for the UAP. Even with a history of hypertension, the act of measuring vital signs itself remains within the realm of basic care. Analysis of incorrect options: B. Assigning the UAP to update the client's medication administration record: updating the MAR involves medication management, verification, and documentation and is a professional responsibility of the nurse; the UAP is not authorized to perform this task. C. Asking the UAP to interpret the client's lab results: interpretation of laboratory findings and analysis of clinical significance require professional medical knowledge and clinical judgment, which are clearly the responsibility of the nurse or physician; the UAP must not perform this task. D. Having the UAP perform the initial nursing assessment: the initial nursing assessment is the foundation of the nursing process, including the collection of subjective and objective data, identification of client problems, and formulation of nursing diagnoses, which is a core professional responsibility of the nurse and may not be delegated to the UAP. In clinical practice, the nurse should base delegation decisions on the stability of the client's condition, the complexity of the task, and the capability of the UAP. For a client with a history of hypertension, although additional attention is needed, basic vital sign monitoring can still be delegated safely to the UAP, while the nurse remains responsible for further assessment, analysis, and decision making.