HIPAA and the American Recovery and Reinvestment Act of 2009 ...

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HIPAA and the American Recovery and Reinvestment Act of 2009 specify that personal health records must be protected. Nurses can protect client privacy by:
 
  1. Whispering when discussing clients in the elevator.
  2. Placing flow sheets on the client's bed.
  3. Not posting clients' names where they can be viewed by visitors.
  4. Sharing passwords with floating nurses.

Question 2

The nurse admits a client who has fallen from a ladder to the Emergency Department with a deep wound on the leg. There is a blood-saturated pressure dressing on the wound.
 
  The nurse assesses the client and finds a heart rate of 128, respirations of 30, and blood pressure of 92/50. The priority action by the nurse at this time is which of the following? 1. Notify the physician immediately.
  2. Reinforce the pressure dressing and elevate the extremity.
  3. Remove the pressure dressing, assess the wound, and apply a new dressing.
  4. Start an IV line for the administration of fluids.

[CourtneyCNorton]

Answer to Question 1

3
Rationale: Healthcare professionals should not discuss clients in public places.

Answer to Question 2

2
Rationale: The client is in shock from blood loss, as indicated by vital signs. The priority action is to prevent further loss of blood by reinforcing the current pressure dressing. Removing the old dressing will result in increased blood loss. While the nurse might need to call the physician, the dressing should be reinforced first in order to prevent further blood loss before the physician arrives. An IV line requires an order, and cannot be placed independently by the nurse.

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