A nurse is caring for an older adult client who has fecal incontinence. Which of the following actions should the nurse take?

Choice A Reason:

To an employer for a pre-employment screening is correct. Generally, healthcare information disclosure to an employer for pre-employment screening requires the client's written consent. The Health Insurance Portability and Accountability Act (HIPAA) and other privacy regulations typically protect a client's health information from disclosure to employers without explicit authorization from the client.

Choice B Reason:

To a medical interpreter service on behalf of a client is incorrect. In situations where a medical interpreter service is required to facilitate communication between the healthcare provider and the client, limited disclosure of health information may be necessary to ensure proper care. However, the information shared should be relevant to the immediate healthcare needs and should not exceed what's necessary for effective communication.

Choice C Reason:

To a family member when the client is not available is incorrect. In certain circumstances, especially if the client is incapacitated or unavailable, disclosing limited health information to a family member might be necessary for the client's best interests, such as for care coordination or emergencies. However, the information shared should be limited to what's essential and relevant to the situation.

Choice D Reason:

To an insurance agency in regard to a life insurance policy is incorrect. Health information disclosure to an insurance agency might be permitted in the context of processing a life insurance policy, typically under the Health Insurance Portability and Accountability Act (HIPAA) and as allowed by state laws. However, this disclosure is usually limited to information necessary for underwriting the policy and may not require the client's explicit written consent.

Choice A Reason:

Turn the client every 4 hr. is incorrect. While repositioning is crucial for preventing pressure ulcers in immobile patients, turning the client every 4 hours might not directly address the issue of fecal incontinence or skin protection in the perineal area.

Choice B Reason:

Cleanse the perineal area with povidone-iodine solution is incorrect. Povidone-iodine solution might be too harsh for routine perineal care and can potentially irritate the skin. A gentler cleansing solution is typically recommended to avoid further skin irritation.

Choice C Reason:

Apply cornstarch powder to the perineal area is incorrect. Cornstarch powder might exacerbate moisture-related skin issues in the perineal area by creating a damp environment, potentially leading to skin maceration and worsening skin problems. It's not typically recommended for use in managing fecal incontinence.

Choice D Reason:

Place a moisture barrier ointment over the perineal area is correct. Using a moisture barrier ointment can help protect the skin from irritation and breakdown caused by prolonged exposure to fecal matter, reducing the risk of skin breakdown and discomfort.