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Zorluk: OrtaEthical Practice

A nurse in a residential substance use treatment facility is caring for a client in the early stages of alcohol withdrawal. The client suddenly reports crushing chest pressure and severe dyspnea. While the nurse is preparing to assess vital signs, the client tearfully discloses that a facility counselor has been sexually abusing them for the past week. Which actions by the nurse are appropriate? Select all that apply.

  1. Initiate emergency medical protocols for the client's acute chest pain and respiratory distress.Cevap
  2. B
    Focus the immediate assessment on gathering detailed information about the abuse to ensure accurate documentation.
  3. Notify the facility administration and the designated state protective agency about the abuse allegation.Cevap
  4. D
    Ask the client, "Why did you wait until today to tell someone about this counselor?"
  5. E
    Delay reporting the abuse allegation until the client has completed withdrawal to confirm the claim's reliability.
  6. Remain continuously with the client and ensure they are secured in an area away from the accused staff member.Cevap

Cevap

The appropriate actions are to initiate emergency medical protocols for the chest pain, notify the facility administration and state protective agency about the abuse, and remain continuously with the client in a safe environment.
The nurse must simultaneously apply clinical prioritization and foundational ethical principles. First, the nurse must address the immediate, life-threatening physiological symptoms (chest pressure and dyspnea) using emergency protocols (Airway, Breathing, Circulation). Simultaneously, the nurse must uphold the ethical principles of beneficence and nonmaleficence by remaining with the client and ensuring they are secured away from the accused abuser. Finally, the nurse has a strict legal and ethical mandate to act as a client advocate by immediately reporting the suspected abuse to the appropriate administrative and state authorities.

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1
Analyze the client's immediate physiological status based on the scenario.
The client is experiencing crushing chest pressure and severe dyspnea, which are indicators of a potential life-threatening cardiovascular or respiratory event.
According to Maslow's hierarchy of needs and the ABCs (Airway, Breathing, Circulation), acute physiological instability must be addressed before any psychosocial interventions.
2
Evaluate the ethical and legal obligations regarding the client's disclosure of sexual abuse.
The nurse identifies an immediate duty to protect the client (nonmaleficence/beneficence) and a legal mandate to report the abuse allegation.
Suspected abuse in a healthcare setting triggers mandatory reporting protocols. The nurse must act immediately to secure the client's safety and notify appropriate authorities, regardless of the client's current withdrawal status.
3
Assess the communication strategies utilized in the options.
The nurse must avoid accusatory or defensive language when responding to a victim of abuse.
Nontherapeutic communication techniques, such as asking 'why' questions, violate the ethical standard of providing compassionate, supportive care and can re-traumatize the client.

Anahtar Kavram

Ethical Practice: Prioritization of Care and Mandatory Reporting
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Konular

Ethical Practice

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