Author Question: A client in labor with the fetus in the vertex position has a spontaneous rupture of membranes. The ... (Read 55 times)

karlynnae · **on:** Jul 22, 2018

A client in labor with the fetus in the vertex position has a spontaneous rupture of membranes. The nurse sees that the amniotic fluid is meconium-stained and immediately:

1. Changes the client's position in bed.
2. Notifies the physician that birth is imminent.
3. Administers oxygen at 2 liters per minute.
4. Begins continuous fetal heart rate monitoring.

Question 2

A client comes to the clinic and is found to have a sexually transmitted disease (STD). The client states to the nurse, Promise you won't tell anyone about my condition..

The nurse, according to the Health Insurance Portability and Accountability Act (HIPAA), must do which of the following? 1. Honor the client's wishes
2. Not disclose any information to anyone
3. Respect the client's privacy and confidentiality
4. Communicate only necessary information

milbourne11 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

4. Begins continuous fetal heart rate monitoring.

Rationale:
Meconium-stained amniotic fluid is an abnormal fetal finding and is an indication for continuous fetal monitoring. Changing the client's position is not indicated. Meconium-stained amniotic fluid does not indicate that birth is imminent. Oxygen administration is not indicated.

Answer to Question 2

4. Communicate only necessary information

Rationale:
HIPAA includes standards that protect the confidentiality, integrity, and availability of data as well as standards that define appropriate disclosures of identifiable health information and patient rights protection. Nurses are entrusted with sensitive information that, at times, must be revealed to other health care personnel in order to provide appropriate health care. In this case, the nurse may be required to report information to the state health department. Honoring the client's wishes would not follow HIPAA standards, since the nurse may be required to report the information to the state health department. Nurses should not make promises to keep necessary information private. While nurses must respect clients' privacy and confidentiality, they are required to report some information to other health care personnel or agencies.