The client is admitted to the hospital following an abortion, and ...

[jho37]

The client is admitted to the hospital following an abortion, and she is septic. The physician orders antibiotics, which the client refuses stating, I don't deserve them.. The nurse providing care has anti-abortion beliefs.
 
  What is the best response by the nurse? 1. I think you need to do what is best for you..
   2. You have a serious infection and really need the drug..
   3. I'll call your physician and let him know about your decision..
   4. Do you think you should be punished because you had an abortion?

Question 2

The nurse is preparing to enter a medication order for a client into the computer system. The physician has ordered that the client be sent home on digoxin .0125 mg qd. When providing the client with discharge instructions, the nurse plans to:
 
  1. Write the medication order exactly as written by the physician.
   2. Mention that the nurse will be contacting the physician because the order is inappropriate.
   3. Write that the client is to take the medication daily.
   4. Give instructions orally only.

[aprice35067]

Answer to Question 1

2. You have a serious infection and really need the drug..

Rationale:
Telling the client she needs the drug is providing the best care possible; this must be done even though the nurse's beliefs are different from the client's beliefs. Telling the client she needs to do what is best is inappropriate; the nurse knows she needs the drug. Calling the physician is inappropriate; the nurse knows the client needs the drug. Asking the client if she thinks she should be punished is inappropriate; she is septic and needs the medication.

Answer to Question 2

3. Write that the client is to take the medication daily.

Rationale:
The nurse would enter the order as 0.0125 mg daily and would include the words daily, or once a day on printed material given to the client. The nurse would change the doctor's order when giving instruction to the client to the correct format, placing a zero before a decimal and changing qd, which can be interpreted incorrectly and should not be used. Saying that the nurse will be contacting the doctor because the order is inappropriate is not necessary; the nurse can interpret the order and write it for the client in an appropriate manner. Oral instructions are appropriate, but written instructions help the client to review instructions if forgotten.