A client with serious medical problems wants to leave the hospital without a physician's discharge order. The client is mentally competent. Legally, the priority nursing action is which of the following?
1. Administer a sedative to keep him from leaving.
2. Find out why the client is leaving, and correct the situation so he will stay.
3. Notify the nursing supervisor.
4. Notify the client's family about the situation.
3
Rationale 1: Answer option 3 is correct because legally, the client has the right to refuse care, and may leave the hospital if he chooses. The nursing supervisor should be notified so the legal interests of the facility, as well as the client's best interest, can be served. The supervisor will explain to the client what could result from his decision and have the client sign an against medical advice (AMA) form. Restraining the client (a sedative is a chemical restraint) is false imprisonment and against the law. If the client chooses to leave anyway, the nurse has increased the danger to the client due to the administration of the sedative. Option 2 is incorrect because the reason the client is leaving is likely beyond the capacity of the nurse to correct. Option 4 is incorrect because this is an invasion of the client's privacy.
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