Legal Issues

A nurse is caring for a client who is receiving hospice care at home. The client's neighbors have been calling the nurse to inquire about the client's condition. The nurse should tell the callers:

"Please call the client's sister" The family is in the best position to give the information they elect to disclose to friends and community members. The hospice nurse and the oncologist must maintain client confidentiality and follow privacy guidelines for release of confidential information. Therefore, disclosing any information about the client's condition would be inappropriate.

A woman employed full-time wants to request a leave of absence to care for her father who is being treated for colon cancer 300 miles (480 km) away. What should the nurse advise the client to do first?

Contact her employee resources department about policies guiding leaves of absence. The nurse should advise the client to check with her employer to determine the policies and legislation followed there regarding leaves of absence. While the client can consider the other options, the first step is to obtain information from her employer.

A nurse is completing an admission assessment with an adult client in a long-term care facility. What are important nursing actions to provide fall safety for the client with dementia in a long-term care facility?

complete the fall risk plan of care identify the client as a high risk for falls establish a toileting program The nurse identifies risk factors, communicates through the plan of care, and establishes a toileting program to minimize the risks for falls. The use of a vest restraint is not a common fall risk implementation especially with a new admission. The client with dementia will not remember to use the call bell.

A 15-year-old client gives birth to a healthy neonate. The neonate's adolescent father arrives on the unit demanding to see his baby. Both sets of grandparents are also present and asking to see their grandchild. The newly hired nurse assigned to the nursery should take which action?

Discuss the unit's policy with the charge nurse. Because the nurse is new to the hospital, she should check with the charge nurse about the unit's visiting policy. The scenario doesn't provide information about whether the neonate's parents are married or if the mother is an emancipated minor. Therefore, the adolescent mother may not be able to legally make her own decisions about her parents' (the baby's grandparents') presence. She or her parents do have a say as to whether the father's parents can visit. The mother of the neonate does have a say in visitors seeing her baby. Because the family dynamics aren't clear in this scenario, the best answer would be to check with the charge nurse who knows the unit's policy. Although the neonate's father may have demanded to see the baby, the question doesn't indicate violent or threatening behavior; therefore, notifying security isn't necessary. The nurse can instruct the father's parents on how to gown and glove before visiting the neonate if they have permission to visit. Because the family dynamics aren't known, inviting everyone to gather in a conference room isn't advisable.

A client whose blood type is A− gives birth to a neonate whose blood type is A+. The client is scheduled to have Rho(D) immune globulin administered. Before administering the medication, which action by the nurse is most important?

Ensuring that the client understands the procedure and signs a consent for the vaccination Before Rho(D) immune globulin administration, the nurse must educate the client about the medication, and the client must sign consent. The nurse should document the procedure after giving the injection. The nurse should advise the client that Rho(D) immune globulin administration will be needed after every pregnancy. Choosing an injection site that isn't tender isn't a priority.

A client was admitted for treatment of the symptoms of bipolar disorder after failing to comply with community treatment and continuing to expose his/her sexual partners to a sexually transmitted form of hepatitis. The court appointed a guardian because this client was not able to understand the consequences of the decisions being made. Which of the following terms describes the status of this client?

Legally incompetent Legally incompetent describes the client who is not able to understand the consequences of decisions. A guardian is appointed for the client who is incompetent. Admitted with consent or voluntary describes a client who is voluntarily admitted and who has the right to demand and obtain release. Emergency involuntary admission is an involuntary admission for a specific time period to prevent dangerous behavior. The term competent describes the client who is able to understand the consequences of decisions.

Entering a client's room, a nurse on the maternity unit sees a mother slapping the face of a crying neonate. Which action should the nurse take in this situation?

Return the neonate to the nursery, inform the physician so he can thoroughly examine the neonate for injuries, and notify social services for assistance. The neonate's safety and protection is the first priority. The nurse should immediately return the neonate to the nursery and inform the physician of the neonate's abuse. By being the neonate's advocate, the nurse allows the physician to examine the neonate for injuries resulting from the incident. Social services should be notified. The neonate shouldn't remain in the room with the mother unsupervised. The nurse should follow the facility's policy and procedure for reporting suspected and actual child abuse. Although the incident may be part of the mother and neonate's revised care plan, it requires immediate intervention, not simple notification of coworkers. Confronting the mother doesn't provide for the neonate's safety.

A nurse is preparing to administer cardiac medications to two clients with the same last name. She checks the medication three times before entering the room to administer medications to the first client. While leaving the room, the nurse realizes she didn't check the client's identification before administering the medication. Which action should the nurse take first?

Return to the room, check the client's identification against the medication administration record, and complete a variance report if needed. The nurse should return to the room to check the client's identification against the medication administration record. If there was an error, the nurse should then complete a variance report in accordance with facility policy and check the remaining medication before administering it to the second client. The client record shouldn't include documentation of a completed variance report. The nurse should inform the charge nurse of the error after she has confirmed that an error has been made.

A 16-year-old client is admitted to the emergency department following an accident. The client sustained a head injury, is unconscious, and has compound fractures of the right tibia and fibula. No family members accompanied the client and none can be reached by phone. The surgeon instructs the nurse to take the client to the operating room immediately. Which of the following actions should the nurse take regarding informed consent?

Take the client to the operating room for surgery without informed consent. The surgeon can take responsibility for consent in this situation because the condition is life (and limb) threatening and delaying the surgical treatment would have a negative impact on the client. The other options would delay the life-saving surgery and would result in negative outcomes for the client. The hospital chaplain has no authority to sign a consent form on behalf of the client.

A nurse is assisting with a circumcision. After the physician has started the procedure, the nurse reviews the neonate's medical record and notices that an informed consent form hasn't been signed. What should the nurse do?

Tell the physician to stop the procedure immediately because an informed consent form hasn't been signed. Parents have the legal right to decide whether their son is circumcised. The nurse and physician should always check the medical record for a signed informed consent form before beginning any procedure. It's unacceptable for the nurse to ask for consent after the procedure. Quickly completing the circumcision is also unacceptable because an informed consent form wasn't signed. Both the nurse and physician were negligent for not checking for a signed informed consent form.