The busy emergency department at a hospital has experienced a sharp increase in negative outcomes among clients with heart conditions in the past month. Which of the following actions should the nursing staff take to improve client outcomes?

A. While track marks could indicate drug use, this alone does not necessitate a report to an outside agency unless there is evidence of harm to self or others, or if there are suspicions of a substance abuse issue that warrants intervention.

B. Emancipated minors have the legal right to make their own medical decisions, including refusing treatment. In this case, the nurse would ensure the patient is informed of the risks of leaving and document the refusal, but there’s no requirement to disclose to an outside agency.
C. A spiral fracture can be indicative of abuse, particularly if the mechanism of injury is not consistent with the explanation provided. In many jurisdictions, healthcare providers are mandated reporters for suspected abuse or neglect in dependent adults.
D. This situation typically does not involve any legal or ethical obligation to report to outside agencies. Glomerulonephritis is a medical condition and does not indicate any need for disclosure, as it does not suggest abuse or neglect.

A. While nurses can verify that a consent form is signed, they do not typically have the authority to ensure it is completed correctly or to explain the details of the procedure, which is the responsibility of the surgeon. The nurse's role is to ensure the client understands the procedure and has had the opportunity to ask questions, but they do not explain the surgery itself in detail.
B. This is a key responsibility of the nurse. Assessing the client's health status before surgery is critical for identifying any potential risks or issues that may affect the surgical outcome. This includes physical assessments and reviewing the client’s medical history.
C. This action is considered outside the nurse's responsibilities. The explanation of the operative procedure, risks, and benefits is typically the responsibility of the surgeon or the physician performing the surgery. Nurses may provide general information or support but are not the ones who explain the specifics of the surgical procedure.
D. Nurses are responsible for reviewing and interpreting preoperative laboratory results to ensure the client is medically ready for surgery. This review helps identify any abnormalities that may need to be addressed before proceeding with the surgical procedure.