Examkin

Soru

Zorluk: ZorClient Rights and Advocacy

An oriented, competent adult client with end-stage renal disease informs the clinical team of their decision to permanently discontinue hemodialysis. Later, the client's adult child confronts the practical nurse (PN) in a busy unit hallway, stating, "My parent is not thinking clearly! You must go in there, explain what will happen without dialysis, and make them sign the consent for tomorrow's treatment." Which action by the PN represents the most appropriate response?

  1. Guide the family member to a private area, affirm the competent client's right to decline medical interventions, and notify the registered nurse.Cevap
  2. B
    Reassure the family member and independently educate the client on the clinical consequences of missing dialysis to secure the consent signature.
  3. C
    Assure the family member that the PN will perform a comprehensive neurocognitive assessment to verify the client's current decision-making capacity.
  4. D
    Discuss the client's deteriorating renal laboratory values with the family member in the hallway to clarify the medical urgency of the situation.

Cevap

The most appropriate response is to guide the family member to a private area, affirm the competent client's right to decline medical interventions, and notify the registered nurse.
The correct response prioritizes client advocacy by upholding the competent client's right to autonomy and self-determination. By moving the conversation to a private area, the practical nurse protects the client's confidentiality. Notifying the registered nurse ensures the interdisciplinary team is appropriately engaged to handle the ethical conflict and family distress.

Adım Adım Çözüm

1
Analyze the client's legal rights regarding the refusal of care.
The client is documented as competent and therefore has the legal right to refuse hemodialysis.
Competent adults possess the legal right of self-determination and autonomy in all medical decisions, regardless of family wishes.
2
Evaluate the environmental and confidentiality factors of the interaction.
The conversation is occurring in a busy hallway, which poses a risk to patient privacy.
Under HIPAA regulations, discussing patient care or family conflicts in a public space risks an unintentional confidentiality breach; the conversation must be relocated.
3
Determine the practical nurse's scope of practice in resolving the family's demand.
The PN must advocate for the client's decision and report the conflict to the RN, but cannot formally obtain consent or perform comprehensive cognitive assessments.
Scope of practice limits the PN to reinforcing education and performing focused assessments. Complex ethical conflicts and primary procedural education must be escalated to the RN and provider.

Anahtar Kavram

Client Autonomy, Confidentiality, and PN Scope of Practice
Tahmini Süre:1m 30s
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Konular

Client Rights and Advocacy

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