A staff nurse was entering patient's clinical notes in the computer, and had to leave to attend an immediate call without completion of recording. Another nurse used the account of the previous nurse to enter her notes.Which of the following BEST describes the ethical issue that was committed?
Answer(s): D
The situation describes a breach of confidentiality, which occurs when private patient information is accessed or disclosed without proper authorization.Negligence: This refers to the failure to provide the standard of care that a reasonably prudent person would provide in a similar situation, but it doesn't specifically address unauthorized access to patient information.Malpractice: This is a type of negligence by a professional, which results in harm to the patient, and usually involves direct patient care rather than record-keeping issues. Breach of Privacy: This involves the inappropriate disclosure of private information. In this case, using someone else's account does not directly disclose patient information to unauthorized parties. Breach of Confidentiality: This specifically addresses the unauthorized access or use of patient information, which is exactly what happened when another nurse used the first nurse's account to enter notes.
Health Insurance Portability and Accountability Act (HIPAA) Guidelines American Nurses Association (ANA): Code of Ethics for Nurses with Interpretive Statements
The nurse assesses a patient with Chronic Renal Failure notes crackles in the lung bases, elevated blood pressure, and weight gain of 1 kg in one day.Based on these finding, which of the following nursing diagnoses is the MOST appropriate for this patient?
The patient's symptoms--crackles in the lung bases, elevated blood pressure, and rapid weight gain--are indicative of fluid overload, which is a common issue in chronic renal failure due to the kidneys' inability to excrete excess fluid.Increased Cardiac Output Related to Fluid Overload: Increased cardiac output would not typically result from fluid overload; rather, fluid overload can lead to decreased cardiac output due to strain on the heart.Ineffective Tissue Perfusion Related to Interrupted Arterial Blood Flow: This diagnosis does not directly correlate with the symptoms of fluid overload observed in this patient. Imbalanced Nutrition More Than Body Requirements Related to Dietary Excess: This diagnosis is not relevant to the observed symptoms, which are more clearly related to fluid retention rather than dietary intake.Excess Fluid Volume Related to the Kidney's Inability to Maintain Fluid Balance: This is the most appropriate nursing diagnosis as it directly addresses the kidney's failure to regulate fluid balance, leading to the observed clinical signs.
National Kidney Foundation: Clinical Practice Guidelines for Chronic Kidney Disease Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
A nurse is seeking best evidence to educate the parents on the use of olive oil for skin care of newborns.Which of the following is the BEST evidence to consider?
The best evidence for educating parents on the use of olive oil for newborn skin care would come from studies that directly compare the use of olive oil to other commonly used baby oils. Studies that Explored the Experience of Using Olive Oil: These may provide qualitative insights but are not the strongest form of evidence for making recommendations. Studies that Considered Pediatrician Opinion on Using Olive Oil: Expert opinion can be valuable but is less robust compared to direct comparative studies.Studies that Assessed Parent's Perception on the Use of Olive Oil: These provide subjective insights and are not as strong as objective comparisons of effectiveness and safety. Studies that Compared the Use of Olive Oil Versus Manufactured Baby Oils: Comparative studies provide direct evidence on the effectiveness and safety of olive oil compared to other products, making them the most reliable source of evidence for making an informed recommendation.
Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice Cochrane Database of Systematic Reviews: Skincare Interventions for Infants
The doctor heard a staff nurse saying "That doctor is incompetent". The doctor can file a complaint against the staff nurse for:
Answer(s): C
The situation described is one where a verbal statement is made that can harm a doctor's reputation.This is best described as slander.Libel: Libel refers to written defamation, not spoken. Assault: Assault involves a threat or attempt to physically harm someone, which is not relevant here. Slander: Slander refers to spoken defamation. The nurse's verbal statement about the doctor's competence falls under this category.Malpractice: Malpractice involves professional negligence that causes harm to a patient, not defamation.
American Nurses Association (ANA): Code of Ethics for Nurses Legal Aspects of Nursing: Documentation, Confidentiality, and Defamation
A nurse is providing education to a new parent about the psychosocial development of the newborn. Applying Erikson's psychosocial development theory, the nurse would BEST instruct the parents to:
Applying Erikson's psychosocial development theory, the nurse should instruct the parents to observe and respond to the newborn's signals of needs. According to Erikson, the first stage of psychosocial development is "Trust vs. Mistrust," which occurs from birth to approximately 18 months.Trust vs. Mistrust: In this stage, infants learn to trust their caregivers when their needs for food, comfort, and affection are consistently met. If caregivers are responsive to the infant's needs, the infant develops a sense of trust and security.Ignoring and Distracting the Newborn: This approach may lead to feelings of mistrust as the infant's needs are not being adequately addressed.Anticipating and Planning for the Newborn's Demands: While planning is important, it is more crucial to be responsive to the infant's immediate signals.Providing a Comfortable Environment: This is beneficial but must be combined with responsive caregiving to establish trust.
Erikson, E. H. (1963). Childhood and Society.American Psychological Association (APA): Erikson's Stages of Psychosocial Development
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