A nurse is caring for a client who has a chest tube with a closed drainage system. Which of the following actions should the nurse take?

Rationale

A. "A client can be discharged to another facility if their behavior is unsafe and inappropriate.": EMTALA focuses on stabilizing medical emergencies, not on behavior-related issues. Discharging solely based on unsafe behavior would violate the client’s right to emergency care.

B. "A client can be discharged to another facility when their condition stabilizes.": EMTALA requires that clients presenting with an emergency medical condition must be evaluated and stabilized before discharge or transfer. This statement reflects proper understanding of the act’s requirement to ensure patient safety and continuity of care.

C. "A client can be discharged to another facility if they are unable to pay for services received.": EMTALA prohibits refusing care or transferring a patient based on inability to pay. Emergency treatment must be provided regardless of financial status, making this statement incorrect.

D. "A client can be discharged to another facility if their condition is terminal.": Terminal status alone does not justify discharge or transfer under EMTALA. The patient must still receive emergency stabilization or palliative support in compliance with legal and ethical requirements.

Rationale

A. Respiratory therapist: Respiratory therapists focus on airway management, pulmonary function, and respiratory interventions. Assistance with dressing is not within their scope of practice and does not relate to pulmonary or ventilatory needs. Reporting dressing difficulties to them would not contribute to the client’s functional recovery.

B. Physical therapist: Physical therapists focus on mobility, strength, range of motion, and gait training. While they may help with lower extremity function, they do not specialize in teaching or assisting with self-care activities like dressing, which is a focus of occupational therapy.

C. Social worker: Social workers address psychosocial needs, discharge planning, and community resources. They are not directly involved in the client’s ability to perform activities of daily living such as dressing, so reporting this information to them would not address the immediate functional concern.

D. Occupational therapist: Occupational therapists specialize in activities of daily living, including dressing, grooming, and self-care. They can assess the client’s functional limitations, recommend adaptive equipment, and provide strategies to enhance independence in dressing following surgery. This ensures the client receives appropriate rehabilitation support.