A nurse is caring for a client whose family member requests to view the client’s medical record. Which of the following responses should the nurse make?
The ethics committee will need to approve this request for you.
I will ask the nursing supervisor to obtain the medical records for you.
The healthcare provider will share this information with you.
The client must provide permission to share the records with you.
The Correct Answer is D
Choice A reason:
The ethics committee does not typically handle requests for access to medical records. Their role is more focused on addressing ethical dilemmas and conflicts in patient care, rather than routine administrative tasks like granting access to medical records.
Choice B reason:
Asking the nursing supervisor to obtain the medical records for a family member is not appropriate without the client’s consent. Medical records are confidential and protected under laws such as HIPAA (Health Insurance Portability and Accountability Act), which require patient authorization for disclosure.
Choice C reason:
The healthcare provider cannot share medical information with a family member without the client’s explicit permission. This is to ensure the privacy and confidentiality of the client’s health information.
Choice D reason:
The correct procedure is for the client to provide permission to share their medical records. Under HIPAA, a healthcare provider can only share a patient’s medical information with family members if the patient has given explicit consent. This ensures that the patient’s privacy rights are respected and that their health information is protected.
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Correct Answer is B
Explanation
Choice A reason: Supported Sims:
The Supported Sims position involves lying on one side with the lower arm behind the back and the upper thigh flexed. This position is not typically recommended for postoperative cholecystectomy patients as it does not provide optimal support for breathing and comfort.
Choice B reason: Semi-Fowler’s:
The Semi-Fowler’s position, where the head of the bed is elevated to about 30-45 degrees, is ideal for postoperative cholecystectomy patients. This position helps facilitate breathing, reduces the risk of aspiration, and promotes comfort by reducing tension on the abdominal muscles.
Choice C reason: Dorsal recumbent:
The Dorsal recumbent position involves lying flat on the back with knees bent and feet flat on the bed. While this position can be used for certain procedures, it is not the most comfortable or beneficial for postoperative cholecystectomy patients as it can increase abdominal pressure and discomfort.
Choice D reason: Prone:
The Prone position, where the patient lies flat on their stomach, is not suitable for postoperative cholecystectomy patients. This position can cause discomfort and does not support optimal breathing or reduce abdominal tension.
Correct Answer is D
Explanation
Choice A reason: A client who has Guillain-Barré syndrome:
Guillain-Barré syndrome (GBS) can cause significant muscle weakness and paralysis, including the muscles involved in swallowing. Clients with GBS are at high risk for aspiration and may require specialized feeding techniques or assistance from a nurse rather than an AP.
Choice B reason: A client who has systemic sclerosis:
Systemic sclerosis, also known as scleroderma, can affect the esophagus and cause difficulty swallowing. These clients may need careful monitoring and assistance with meals to prevent choking and ensure adequate nutrition.
Choice C reason: A client who has amyotrophic lateral sclerosis (ALS):
ALS affects the motor neurons and can lead to progressive muscle weakness, including the muscles involved in swallowing. Clients with ALS often require specialized feeding techniques and close monitoring during meals to prevent aspiration.
Choice D reason: A client who has a lumbosacral spinal tumor:
A lumbosacral spinal tumor primarily affects the lower back and may cause pain or mobility issues, but it does not typically impair swallowing. Therefore, this client is the most appropriate for the AP to assist with meals, as they are less likely to have complications related to eating.