A nurse is caring for a client who is obese. The client is crying and states, "Everyone is staring at me because of my weight." Which of the following responses should the nurse make?

Rationale:

A. Email the client's health information to the facility in an unencrypted file: Sending unencrypted emails violates HIPAA standards, as it risks unauthorized access to protected health information. All electronic transmissions must be secured to ensure client confidentiality.

B. Fax the client's name and identifiable information to the rehabilitation: Faxing identifiable information can be permissible if proper safeguards are used, but without assurance of security or a cover sheet, this could breach confidentiality. It’s not the best initial action without those protections.

C. Discuss the client's response to the transfer with another staff nurse: Unless the other nurse is directly involved in the client’s care, this discussion is unnecessary and breaches confidentiality. Health information should only be shared on a need-to-know basis.

D. Provide a verbal report of the client's condition to the paramedic: Providing a verbal handoff to the paramedic is appropriate and necessary for continuity of care during transfer. It is a secure, direct communication method that supports both confidentiality and patient safety.

Rationale:

A. Wear a dosimeter film badge to measure exposure: A dosimeter badge tracks the cumulative radiation exposure for healthcare workers. It is essential for staff safety when caring for clients with internal radiation therapy.

B. Discard bed linens from the client's room at the end of each day: Linens should not be discarded unless contaminated. They are usually kept in the room until radiation is removed to avoid unnecessary exposure to other staff or areas.

C. Instruct visitors to remain 61 cm (2 feet) away from the client: Visitors should maintain a greater distance typically at least 6 feet (about 2 meters) and limit their visit time (usually to 30 minutes or less). Two feet is insufficient to minimize radiation exposure.

D. Place a caution sign on the client's door: Posting a radiation warning sign helps alert all personnel and visitors about radiation precautions, promoting safety and compliance with guidelines.

E. Don a lead apron when providing care: A lead apron protects the nurse from radiation exposure, especially when prolonged or close contact is necessary. It is a critical part of personal protective equipment in this setting.