A nurse is caring for an older adult client who has advanced dementia and needs a blood transfusion. The client previously designated her adult daughter on a durable power of attorney for health care form, and the daughter refuses the treatment. Which of the following actions should the nurse take?
Ask the provider to give consent for the transfusion.
Discuss taking guardianship of the client with the facility administration.
Respect the daughter's decision to refuse the transfusion.
Encourage the daughter to let her mother have the transfusion.
The Correct Answer is C
A) Ask the provider to give consent for the transfusion:
The provider cannot override the decision made by the client's designated healthcare proxy. Even if the provider were to give consent for the transfusion, it would not be ethically or legally appropriate to proceed with the treatment against the expressed wishes of the client's healthcare proxy.
B) Discuss taking guardianship of the client with the facility administration:
Seeking guardianship of the client would be an extreme measure and may not be necessary or appropriate in this situation. Guardianship is typically pursued when there are concerns about an individual's capacity to make decisions for themselves and when there is no designated healthcare proxy available to make decisions on their behalf. In this case, the client has a designated healthcare proxy, and it is more appropriate to respect the daughter's decision as the client's authorized representative.
C) Respect the daughter's decision to refuse the transfusion:
In situations where a client has designated a durable power of attorney for healthcare, the individual designated as the healthcare proxy has the legal authority to make healthcare decisions on behalf of the client, including the refusal of treatment. In this case, the daughter, acting as the client's healthcare proxy, has refused the blood transfusion for her mother. It is important for the nurse to respect and honor the daughter's decision, as it aligns with the client's previously documented wishes.
D) Encourage the daughter to let her mother have the transfusion:
While it is understandable that the nurse may want to advocate for the client's well-being, in this situation, the daughter's decision as the client's healthcare proxy must be respected. Encouraging the daughter to change her decision would not be appropriate if it goes against her understanding of what is in her mother's best interests and the client's previously documented wishes.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Restraining a client without a provider's prescription:
This action represents assault and false imprisonment rather than negligence. Assault involves the threat of harm or unwanted touching, while false imprisonment involves the unlawful restraint or restriction of a person's freedom of movement.
B) Threatening to administer a medication a client has refused:
Threatening to administer a medication against a client's wishes may constitute assault or battery, depending on the circumstances, but it does not directly relate to negligence unless the threat results in harm due to the nurse's failure to adhere to the standard of care.
C) Failing to notify the provider after a medication error:
Negligence involves a breach of duty of care resulting in harm to another person. Failing to notify the provider after a medication error represents negligence because it breaches the duty of care owed to the client and may result in harm if appropriate actions are not taken promptly to mitigate the error's effects.
D) Documenting false information in a client's medical record:
Documenting false information in a client's medical record is a form of falsifying documentation and can have serious consequences, including legal and professional repercussions. However, it does not directly relate to negligence unless the false documentation leads to harm or adverse outcomes for the client.
Correct Answer is B
Explanation
A) Informed consent:
While informed consent documents provide information about the proposed surgical procedure, they typically do not include information about organ donation. Informed consent focuses on the risks, benefits, and alternatives of the procedure being performed, as well as the client's agreement to undergo the procedure.
B) Advance directives:
Advance directives, such as a living will or healthcare proxy, can contain information about a client's preferences regarding organ donation. These documents specify the client's wishes regarding medical interventions, including organ donation, in the event that they become incapacitated and unable to make decisions for themselves. Advance directives guide healthcare providers and family members in honoring the client's preferences regarding end-of-life care and organ donation.
C) Do-not-resuscitate order:
A do-not-resuscitate (DNR) order instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. While organ donation preferences may be discussed in the context of end-of-life care decisions, a DNR order specifically pertains to resuscitative measures and does not provide information about organ donation.
D) Provider's prescription:
A provider's prescription typically pertains to specific medications or treatments ordered by the healthcare provider for the client's care. It does not typically contain information about organ donation. Organ donation preferences are typically documented in advance directives or other specific forms related to donation programs.
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