A nurse is caring for a group of patients on an adult medical-surgical unit.
Which patient should the nurse identify as having the highest risk for aspiration?

Choice A rationale:

Incorrect. Patients have a legal right to access their medical records under the Health Information Portability and Accountability Act (HIPAA). Denying access is a violation of patient rights and could lead to legal consequences.

Undermines patient autonomy and trust. Patients have a right to know what information is in their medical records and to participate in their own healthcare decisions. Denying access can erode trust in the healthcare system.

Potential for errors and misunderstandings. If patients cannot review their records, they may not be able to identify errors or misunderstandings that could impact their care.

Choice B rationale:

Correct. This response upholds patient rights while ensuring that the request for access is documented and handled appropriately.

Protects patient privacy and confidentiality. The written request process helps to ensure that only the patient or their authorized representative has access to the records.

Provides a mechanism for tracking and auditing access requests. This can help to prevent unauthorized access and ensure compliance with HIPAA regulations.

Choice C rationale:

Incorrect. Patients have a right to access their records at any time, not just when they are being discharged.

Delays access to information. Patients may need to review their records to make informed decisions about their care, even if they are not being discharged.

Potential for records to be lost or misplaced. There is a risk that records could be lost or misplaced if they are not provided to the patient until discharge.

Choice D rationale:

Incorrect. Patients do not need to provide a reason for wanting to access their medical records.

Intrusive and unnecessary. Patients may feel uncomfortable or embarrassed about having to explain their reasons for wanting to access their records.

Potential for discrimination. Patients may be less likely to request access to their records if they feel that they will be judged or questioned about their reasons for doing so.

Choice A rationale:

Chronic pain can manifest in various behavioral and physical symptoms, including restlessness, pacing, grimacing, and other facial expressions of pain. These behaviors are often unconscious attempts to cope with or distract from the pain.

They may also reflect the emotional distress that often accompanies chronic pain. Patients may feel frustrated, anxious, or even depressed due to the persistent nature of their pain and its impact on their lives.

It's crucial for nurses to recognize these behavioral signs of pain, as patients may not always readily report their pain verbally. By observing these behaviors, nurses can assess the patient's pain level more accurately and provide appropriate interventions.

Choice B rationale:

Chronic pain is defined as pain that persists for longer than three months, often for much longer. It is not limited and short in duration.

This distinguishes it from acute pain, which is typically associated with an injury or illness and resolves within a few days or weeks.

Choice C rationale:

While some patients with chronic pain may have physical signs of tissue injury, this is not always the case. Chronic pain can also be caused by nerve damage, inflammation, or changes in the central nervous system.

In some cases, the underlying cause of chronic pain may be unknown.

Choice D rationale:

Although chronic pain may not always cause a significant change in vital signs, it can still be a very real and debilitating experience for patients.

Vital signs, such as heart rate, blood pressure, and respiratory rate, are often more sensitive to acute pain.

Nurses should not rely solely on vital signs to assess chronic pain. Instead, they should consider the patient's self-report of pain, behavioral cues, and other factors.