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Soru

Zorluk: ZorClient Rights and Advocacy

A practical nurse (PN) is caring for a 55-year-old client who is alert, oriented, and scheduled for a cardiac catheterization later in the day. The client's adult child, who is the designated healthcare proxy, pulls the PN aside and states, 'My parent seemed confused earlier. Please put up all four of their bed rails, explain the exact risks of the procedure to them again, and let me look at their morning laboratory results.' Which of the following actions should the PN take? (Select all that apply.)

  1. Inform the adult child that the laboratory results cannot be shared without the client's explicit permission.Cevap
  2. B
    Raise all four bed rails immediately to ensure safety based on the family member's observations.
  3. Notify the supervising registered nurse (RN) about the family member's report regarding the client's confusion.Cevap
  4. D
    Explain the specific physiological risks and alternative treatments for the cardiac catheterization to the client.
  5. Reinforce to the adult child that the healthcare proxy designation only activates if the client loses decision-making capacity.Cevap
  6. F
    Conduct a comprehensive cognitive assessment to formally determine if the client's healthcare proxy should be activated.

Cevap

The correct actions are to inform the child that laboratory results cannot be shared without permission, notify the RN about the reported confusion, and reinforce that the proxy only activates if the client loses capacity.
The correct actions prioritize client confidentiality, adhere to the practical nurse's scope of practice, and ensure safe escalation of care. Because the client is competent, the healthcare proxy is inactive, meaning the family has no right to view medical records or make decisions without the client's consent. The PN correctly advocates for the client by enforcing these boundaries and appropriately reports the new symptom of confusion to the RN.

Adım Adım Çözüm

1
Analyze the family member's request to view laboratory results and act as the decision-maker.
The nurse identifies that the client is currently alert and oriented, meaning the healthcare proxy is not legally active.
Under HIPAA guidelines, medical information cannot be shared without a competent client's explicit permission, and a proxy cannot override a competent client.
2
Evaluate the family member's request to explain the surgical risks to the client.
The nurse recognizes that explaining procedural risks and alternative treatments is solely the responsibility of the healthcare provider.
The practical nurse's role in informed consent is limited to witnessing the signature and ensuring the provider has already explained the procedure, maintaining strict scope of practice boundaries.
3
Assess the requests for applying four bed rails and the report of new-onset confusion.
The nurse determines that raising four bed rails is a physical restraint that requires alternatives and an order, and formal cognitive assessment is beyond the PN scope.
Less restrictive safety measures must be attempted first, and any reported changes in mental status must be communicated to the supervising RN for a comprehensive evaluation.

Anahtar Kavram

Client Rights, Advocacy, and PN Scope of Practice
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Konular

Client Rights and Advocacy

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