In which situation is the nurse allowed to breach a client's right to confidentiality?

The client's spouse: While the spouse may be a close family member and have significant input into the client's medical decisions, the ultimate authority for decisions like a DNR order rests with the client, assuming they are competent to make their own decisions.

The client's only child: Similar to the spouse, a child can have an emotional and supportive role in the decision-making process, but unless legally designated as the healthcare proxy or power of attorney for healthcare decisions, they do not typically have the legal authority to make decisions for a competent adult.

The client: In the context of medical decision-making, the principle of patient autonomy is fundamental. If the client is competent and capable of making decisions, their wishes and consent are paramount. In the case of a DNR order, it should be discussed thoroughly with the client, ensuring they understand the implications, risks, and benefits before making an informed decision.

Any close blood-related relative: In general, the authority to make medical decisions, including DNR orders, is not automatically granted to any blood-related relative. The client or their legally appointed representative (such as a healthcare proxy) usually holds this authority.

A) Restore the client's system to an optimal state of balance:
This statement is not accurate for tertiary intervention. Tertiary intervention primarily focuses on managing and preventing complications or disabilities resulting from an illness or condition. It does not necessarily aim to restore the client's system to an optimal state of balance, as that is more aligned with primary and secondary prevention strategies.

B) Treating symptoms that stressors have already produced:
This statement is correct. Tertiary intervention aims to address and manage the symptoms, disabilities, or complications that have resulted from stressors or illnesses. It focuses on providing appropriate treatments, rehabilitation, and support to improve the client's quality of life and prevent further complications.

C) Preventing symptoms caused by environmental stressors:
This statement is not accurate for tertiary intervention. Tertiary intervention deals with managing existing symptoms or complications rather than preventing new symptoms caused by environmental stressors.

D) Teaching cultural perspectives of environmental stressors:
This statement is not directly related to tertiary intervention. Tertiary intervention focuses on providing medical treatments, therapies, and support to individuals with existing conditions, rather than teaching cultural perspectives.