A nurse is providing education about when health care referrals would be appropriate. When should a healthcare provider order a referral?

Choice A Reason:

“Call the provider” is important but not the first priority. The immediate concern is to maintain the client’s intravenous access to ensure they can receive any necessary medications or fluids promptly. Once the line is secured, the provider should be notified to receive further instructions and manage the client’s condition.

Choice B Reason:

“Notify the blood bank” is also crucial but comes after ensuring the client’s immediate safety. The blood bank needs to be informed to investigate the cause of the reaction and prevent further issues, but this step follows the initial emergency interventions.

Choice C Reason:

“Collect a urine specimen” is necessary to check for hemolysis, which can occur during a transfusion reaction. However, this is not the first step. The priority is to stabilize the client by maintaining IV access with normal saline.

Choice D Reason:

“Keep the line open with 0.9% NS through new tubing” is the correct first intervention. This action ensures that the client remains hydrated and that the IV line is available for any emergency medications or treatments. Using new tubing prevents any contamination from the transfusion set.

Choice A Reason:

The client’s immediate family members may not always have the right to access the client’s protected health information (PHI) unless the client has given explicit consent. Confidentiality laws, such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States, are designed to protect the privacy of patients’ health information. These laws generally require that PHI be shared only with individuals who are directly involved in the patient’s care or who have been authorized by the patient. Therefore, while family members may be involved in the patient’s care, they do not automatically have the right to access PHI without the patient’s consent.

Choice B Reason:

The facility’s administrators typically do not need access to a specific client’s PHI unless it is necessary for administrative purposes related to the patient’s care or for compliance with legal and regulatory requirements. Administrators are generally more involved in the overall management and operation of the healthcare facility rather than in the direct care of individual patients. Sharing PHI with administrators without a valid reason could violate confidentiality laws and the patient’s right to privacy.

Choice C Reason:

Health care team members caring for the client are directly involved in the patient’s care and, therefore, have a legitimate need to access the client’s PHI. This includes doctors, nurses, therapists, and other healthcare professionals who are providing treatment, coordinating care, or ensuring the patient’s well-being. Sharing PHI with these individuals is essential for delivering safe and effective care, and it is permitted under confidentiality laws such as HIPAA.

Choice D Reason:

Clergy affiliated with the facility may provide spiritual support to patients, but they do not typically have a legitimate need to access the client’s PHI unless the patient has given explicit consent. While spiritual care is an important aspect of holistic healthcare, it does not require access to detailed medical information. Therefore, sharing PHI with clergy without the patient’s consent would generally be considered a violation of confidentiality laws.