The home health nurse is providing palliative care to a client. ...

[armygirl]

The home health nurse is providing palliative care to a client. When sorting the client's narcotic pain medications for the week, the nurse notes that there is two weeks' worth of medication missing from the client's current prescription.
 
  The client says that the only individuals with access to the medication include the client and one other home healthcare nurse. The nurse suspects that the other home healthcare nurse took the missing mediation. Which action by the nurse is appropriate?
  A) Call the state board of nursing.
  B) Tell the client to confront the other nurse.
  C) Call the authorities immediately.
  D) Have the client file a police report.

Question 2

An older adult client with metastasized breast cancer informs the nurse that her doctor is insisting that she participate in a course of chemotherapy, even though the client does not want to have any further treatment. Which actions by the nurse exemplify
 
  Select all that apply.
  A) Tell the client that it is in her best interest to follow the doctor's advice.
  B) Inform the doctor about the client's clear wishes not to have further chemotherapy.
  C) Ascertain whether or not the client has an advanced care directive and, if not, assist her in creating one.
  D) Discuss the implications of various choices with the client.
  E) Avoid interfering in the doctor-patient relationship.

[dmurph1496]

Answer to Question 1

Answer: A

Nurses have a legal responsibility to report any professional whom they suspect of engaging in illegal, immoral, or unethical activities. Normally, the nurse making such a report will do so following established procedures at the facility at which the nurse is employed. A nurse who suspects another nurse of impairment should also follow guidelines set forth by the board of nursing for the state in which he or she works. At other times, the nurse may need to seek the guidance of the state board of nursing or the American Nurses Association (ANA). A nurse who suspects a colleague of engaging in illegal, immoral, or unethical conduct and fails to act is in direct violation of the ANA Code of Ethics for Nurses

Answer to Question 2

Answer: B, C, D

Nurses acting as advocates should honor the moral principles and standards and respect clients' right to make their own choices. The nurse should continuously advocate for the client in a professional manner. The nurse serves as both a teacher and an advocate by informing clients about their rights. When the client makes decisions about his or her treatment other than what is recommended, it is the nurse's role to ensure that the client is making an informed decision and, if so, to advocate for the client's right to make autonomous choices.