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Difficulty: HardClient Rights and Advocacy

An adult client with advanced liver disease is admitted for hepatic encephalopathy management. The client is currently oriented to person only and has a legally designated healthcare proxy. Which of the following actions by the practical nurse (PN) correctly uphold the client's rights and legal protections? Select all that apply.

  1. Declining to provide a clinical prognosis update to the client's visiting sibling.Answer
  2. B
    Explaining the potential complications of a scheduled therapeutic paracentesis to the healthcare proxy.
  3. Documenting and reporting the client's physical resistance to the morning blood draw as a refusal of care.Answer
  4. D
    Applying bilateral soft wrist restraints to prevent the confused client from dislodging their intravenous line.
  5. E
    Waiting to obtain definitive financial records before reporting suspected financial exploitation by a caregiver.
  6. Arranging for a certified medical interpreter when explaining routine daily care measures to the non-English-speaking healthcare proxy.Answer

Answer

The correct actions include declining to share information with unauthorized family members, recognizing physical resistance as a refusal of care despite confusion, and utilizing a certified interpreter for the non-English-speaking proxy.
Appropriate advocacy involves adhering to HIPAA by denying unauthorized updates, protecting bodily autonomy by treating physical resistance as a valid refusal of care, and ensuring equitable care by using certified interpreters for legally designated decision-makers.

Step-by-Step Solution

1
Evaluate the client's capacity and the role of the healthcare proxy.
The client is confused but retains basic rights to bodily autonomy; the proxy is the legal decision-maker but not the target for nursing-led procedural education.
Understanding legal roles prevents scope of practice violations during informed consent.
2
Analyze each option against confidentiality laws (HIPAA) and mandated reporting statutes.
Sharing data with the sibling breaches confidentiality; waiting for proof of abuse violates immediate mandated reporting duties.
Client advocacy requires strict adherence to privacy and immediate protection from potential harm.
3
Assess the interventions related to direct care and restraints.
Restraints cannot be a first-line intervention, and physical resistance to a blood draw must be honored as a refusal.
Clients have the right to the least restrictive environment and the right to refuse treatment at any time.

Key Concept

Practical nurses advocate for clients by maintaining strict confidentiality, honoring refusal of care (even in confused clients), using appropriate interpreter services, fulfilling mandated reporting duties immediately, and remaining within their legal scope of practice regarding informed consent.
Estimated Time:1m 30s
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Client Rights and Advocacy

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