A client who recently experienced a severe cerebrovascular accident is admitted to a palliative care unit. The client is nonverbal and accompanied by multiple relatives who are expressing conflicting opinions about the plan of care. Which actions by the practical nurse demonstrate adherence to legal and ethical standards? Select all that apply.
- Verifying the medical record for a designated durable power of attorney for healthcare before disclosing clinical updates to the visiting relatives.Answer
- BExplaining the potential risks and benefits of a proposed percutaneous endoscopic gastrostomy (PEG) tube to the family to expedite the consent process.
- Documenting and immediately reporting to the facility supervisor an incident where a relative forcefully grabbed the client's arm, causing a skin tear.Answer
- DAccepting an assignment to administer the client's initial intravenous push (IVP) dose of morphine sulfate to assist the busy registered nurse (RN).
- EProviding a brief condition update over the telephone to an individual identifying themselves as the client's primary religious leader.
- Declining to witness the signature on an informed consent document after determining the family surrogate does not understand the planned procedure.Answer
Answer
The correct actions are verifying the medical record for a designated healthcare proxy before disclosing clinical updates, reporting the relative's aggressive behavior to the supervisor, and declining to witness the informed consent signature if the surrogate lacks understanding.
The practical nurse demonstrates adherence to legal and ethical standards by strictly maintaining confidentiality (verifying the legal proxy before sharing information), fulfilling the duty of nonmaleficence and mandatory reporting (reporting the relative's aggressive behavior), and advocating for true informed consent (refusing to witness a signature if the surrogate does not understand the procedure). These actions protect the vulnerable client's rights, privacy, and safety.
Step-by-Step Solution
Key Concept
The practical nurse must strictly adhere to the legal boundaries of their scope of practice, maintain strict confidentiality, fulfill mandatory reporting requirements for abuse, and ensure informed consent processes are legally valid.