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Zorluk: OrtaClient Rights and Advocacy

A practical nurse is caring for an alert and oriented older adult client whose discharge is scheduled for later in the day. The client's adult child, who is the designated healthcare proxy, arrives and states, "I am taking my parent to a memory care facility right now." The client privately tells the nurse, "I do not want to go there. I live independently and I want to go back to my own house." Which of the following is the most appropriate action for the practical nurse to take?

  1. Notify the charge nurse and the facility social worker immediately about the client's stated wishes.Cevap
  2. B
    Explain to the client that the designated healthcare proxy has the legal authority to make the final discharge decision.
  3. C
    Coordinate the cancellation of the memory care transfer and independently arrange for home health services.
  4. D
    Ask the client's roommate if the client had previously expressed a desire to return home instead of the facility.

Cevap

Notify the charge nurse and the facility social worker immediately about the client's stated wishes.
The correct action is to notify the interdisciplinary team (charge nurse and social worker). A designated healthcare proxy only makes medical decisions when the client is deemed legally incompetent or unable to make their own decisions. Because this client is alert and oriented, they retain the right to self-determination regarding their discharge location. The practical nurse advocates for the client by ensuring the appropriate team members are aware of this conflict so it can be legally and safely resolved.

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1
Assess the client's current cognitive status and legal rights.
The client is alert and oriented, meaning they retain the right to self-determination and their healthcare proxy is not currently active.
Understanding when a healthcare proxy takes effect is crucial for protecting client rights.
2
Identify the conflict requiring advocacy.
There is a direct conflict between the competent client's wishes and the family member's intent, creating a high-risk discharge scenario.
Nurses have an ethical and legal duty to advocate for the client's stated preferences, even when family members disagree.
3
Determine the appropriate scope of practice for the practical nurse.
The nurse escalates the complex ethical and legal discharge conflict to the charge nurse (RN) and social worker.
Practical nurses must recognize situations that require interdisciplinary collaboration and RN-level case management.

Anahtar Kavram

Client Rights, Self-Determination, and Advocacy
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