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 A
Explanation
Choice A: Office of Emergency Management (OEM)
The Office of Emergency Management (OEM) is typically the first agency to be notified in the event of a nonbiological or chemical incident. The OEM coordinates the local response efforts and ensures that all necessary resources and personnel are mobilized. They work closely with other local, state, and federal agencies to manage the incident effectively. The OEM’s role includes assessing the situation, providing information to the public, and coordinating evacuation or shelter-in-place orders if necessary.
Choice B: Federal Emergency Management Agency (FEMA)
The Federal Emergency Management Agency (FEMA) plays a crucial role in disaster response and recovery at the federal level. However, they are usually involved after the initial local response has been established. FEMA provides support and resources to local and state agencies, but the immediate notification should go to the local Office of Emergency Management.
Choice C: American Red Cross (ARC)
The American Red Cross (ARC) is a vital organization in disaster response, providing emergency shelter, food, and medical care. While they are an essential part of the response team, they are not typically the first agency to be notified. The ARC works in coordination with local emergency management agencies to support the affected community.
Choice D: U.S. Department of Homeland Security (DHS)
The U.S. Department of Homeland Security (DHS) oversees national efforts to protect against and respond to various threats, including chemical incidents. However, like FEMA, DHS is generally involved at a higher level of coordination and support. The immediate response is managed by local agencies, with DHS providing additional resources and expertise as needed
Correct Answer is B
Explanation
Choice A: Induce Sedation
Pancuronium is not used to induce sedation. It is a neuromuscular blocking agent (NMBA) that causes paralysis of skeletal muscles. Sedation is typically achieved using medications such as benzodiazepines or propofol, which act on the central nervous system to produce a calming effect.
Choice B: Suppress Respiratory Effort
Pancuronium is used to suppress respiratory effort in patients with ARDS who require mechanical ventilation. By causing muscle paralysis, pancuronium helps to synchronize the patient’s breathing with the ventilator, reducing the risk of ventilator-induced lung injury and improving oxygenation. This is particularly important in severe cases of ARDS where patient-ventilator dyssynchrony can be detrimental.
Choice C: Decrease Chest Wall Compliance
Decreasing chest wall compliance is not a purpose of pancuronium. In fact, pancuronium does not directly affect chest wall compliance. Instead, it works by blocking the transmission of nerve impulses to the muscles, leading to muscle relaxation and paralysis.
Choice D: Decrease Respiratory Secretions
Pancuronium does not decrease respiratory secretions. Medications such as anticholinergics (e.g., atropine) are used to reduce secretions. Pancuronium’s primary role is to facilitate mechanical ventilation by ensuring complete muscle relaxation.
