A home health nurse is evaluating an older adult client who has multiple unexplained bruises in various stages of healing. During the assessment, the client tearfully confides that their primary caregiver caused the injuries but begs the nurse not to tell anyone, expressing intense fear of being moved to a care facility. Which action by the nurse represents the most appropriate ethical and legal response?
- Report the suspected abuse to the designated state adult protective agency despite the client's request for secrecy.Cevap
- BHonor the client's request for confidentiality to maintain trust and the therapeutic relationship.
- CAsk the client why the caregiver became violent to better understand the underlying family dynamics.
- DFocus solely on applying wound care to the bruises and assess for new injuries during the next scheduled visit.
Cevap
The most appropriate action is to report the suspected abuse to the designated state adult protective agency despite the client's request for secrecy.
The correct action involves reporting the suspected abuse to the designated state agency. In nursing ethics, while confidentiality and autonomy are fundamental, they are not absolute. When a vulnerable adult is at risk of significant harm, the ethical duty of nonmaleficence and the legal mandate of mandatory reporting supersede the client's request for secrecy.
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Limits of confidentiality and mandatory reporting of elder abuse
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