A client's family members are concerned that telling the client about a new finding of cancer will cause extreme emotional distress. They approach the nurse and ask if this can be kept from the client. What actions by the nurse are most appropriate?
(Select all that apply.)
a.
Ask the family to describe their concerns more fully.
b.
Consult with a social worker, chaplain, or ethics committee.
c.
Explain the client's right to know and ask for their assistance.
d.
Have the unit manager take over the care of this client and family.
e.
Tell the family that this secret will not be kept from the client.
ANS: A, B, C
The client's right of autonomy means that the client must be fully informed as to his or her diagnosis and treatment options. The nurse cannot ethically keep this information from the client. The nurse can ask the family to explain their concerns more fully so everyone understands the concerns. A social worker, chaplain, or ethics committee can become involved to assist the nurse, client, and family. The nurse should explain the client's right to know and ask the family how best to proceed. The nurse should not abdicate responsibility for this difficult situation by transferring care to another nurse. Simply telling the family that he or she will not keep this secret sets up an adversarial relationship. Explaining this fact along with the concept of autonomy would be acceptable, but this by itself is not.
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During afternoon rounds, the nurse finds a male patient using a pencil to scratch inside his knee-to-toe cast. The patient is complaining of severe itching in the ankle area. Which action should the nurse take?
A) Allow him to continue to scratch inside the cast with a pencil. B) Give him a sterile metal object to use for scratching instead of the pencil. C) Encourage him to avoid scratching, and obtain an order for diphenhydramine (Benadryl) if severe itching persists. D) Obtain an order for a sedative, such as diazepam (Valium), to prevent him from scratching.
Most nonsteroidal anti-inflammatory drugs (NSAIDs) are believed to work by inhibiting the synthesis of:
a. histamine. c. leukocytes. b. cortisol. d. prostaglandins.
Referred pain originates in the:
a. skin. b. mucous membrane. c. visceral organs. d. blood vessels.
The nurse is using an elastic bandage to secure a dressing on an extremity. The bandage should be wrapped in the ___________ to ___________ direction
What will be an ideal response?