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Zorluk: Çok zorClient Rights and Advocacy

A practical nurse (PN) is providing care for a young adult client admitted to a behavioral health unit under a temporary involuntary hold following a substance overdose. The client is highly agitated, pacing the hallway, and stating, 'I know my rights, I want to leave right now, and I want a copy of my medical chart!' Simultaneously, the client's parent calls the nursing station requesting the latest toxicology lab results. Which actions by the PN are appropriate? (Select all that apply.)

  1. Decline to confirm the client's presence at the facility or provide any laboratory results to the calling parent.Cevap
  2. B
    Print the requested medical record and hand it to the client immediately to help de-escalate the pacing behavior.
  3. C
    Apply soft bilateral wrist restraints to prevent the client from eloping from the locked behavioral unit.
  4. Calmly inform the client that they are legally required to remain at the facility due to the involuntary hold status.Cevap
  5. Communicate the client's request to view their medical record to the supervising registered nurse.Cevap
  6. F
    Explain the detailed risks and benefits of the facility's detoxification protocols to obtain the client's informed consent.

Cevap

The appropriate actions are to decline sharing information with the calling parent, inform the client of their legal hold status, and report the medical record request to the supervising registered nurse.
The practical nurse acts as a client advocate by protecting strict confidentiality (refusing the parent's request), informing the client of their legal rights and restrictions (explaining the involuntary hold), and escalating complex requests (like accessing a psychiatric medical record) to the registered nurse. Providing factual information about the hold manages the client's expectations, while declining the parent's request strictly adheres to HIPAA guidelines.

Adım Adım Çözüm

1
Evaluate the parent's phone request for lab results against HIPAA regulations.
Determine that without explicit client authorization, no information, including confirmation of the client's presence, can be disclosed.
Protects client confidentiality and complies with federal privacy laws.
2
Analyze the client's demand to leave the facility against their legal admission status.
Identify that the temporary involuntary hold legally supersedes the general right to leave against medical advice.
Ensures the client is safely and truthfully informed of their legal boundaries.
3
Assess the client's request to immediately view their medical chart in the context of the PN scope of practice.
Determine that while clients have a right to their records, the provider must often review psychiatric records first, requiring escalation to the RN.
Maintains safe practice boundaries, avoids out-of-scope clinical judgment, and follows proper chain of command.
4
Evaluate the appropriateness of applying physical restraints or obtaining informed consent.
Recognize that restraints require prior less restrictive alternatives and provider orders, and obtaining initial informed consent is strictly a provider responsibility.
Prevents severe scope of practice violations and client rights infringements.

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Client Rights and Advocacy
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Client Rights and Advocacy

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