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Zorluk: ZorLegal and Ethical Practice

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.

  1. Verifying the medical record for a designated durable power of attorney for healthcare before disclosing clinical updates to the visiting relatives.Cevap
  2. B
    Explaining the potential risks and benefits of a proposed percutaneous endoscopic gastrostomy (PEG) tube to the family to expedite the consent process.
  3. Documenting and immediately reporting to the facility supervisor an incident where a relative forcefully grabbed the client's arm, causing a skin tear.Cevap
  4. D
    Accepting an assignment to administer the client's initial intravenous push (IVP) dose of morphine sulfate to assist the busy registered nurse (RN).
  5. E
    Providing a brief condition update over the telephone to an individual identifying themselves as the client's primary religious leader.
  6. Declining to witness the signature on an informed consent document after determining the family surrogate does not understand the planned procedure.Cevap

Cevap

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.

Adım Adım Çözüm

1
Analyze the clinical scenario involving a nonverbal client, conflicting family members, and complex care needs.
Recognize that the situation involves multiple overlapping legal and ethical issues, including confidentiality (HIPAA), scope of practice, informed consent, and mandatory reporting.
Identifying the core legal and ethical themes is necessary to evaluate the appropriateness of each nursing action.
2
Evaluate each action against the standard practical nurse (PN) scope of practice and legal mandates.
Determine that verifying legal proxies, reporting abuse, and advocating during the consent process fall within legal and ethical duties.
The PN must practice safely within legal boundaries, protecting the client's rights and safety while avoiding actions reserved for the provider or registered nurse.
3
Identify and reject actions that violate these boundaries.
Reject explaining procedure risks (provider role), administering IVP morphine (RN role), and giving telephone updates to unverified callers (HIPAA violation).
Performing out-of-scope tasks or breaching confidentiality jeopardizes client safety and the nurse's licensure.

Anahtar Kavram

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.
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