A client is admitted to an inpatient unit with a diagnosis of frontotemporal dementia. Which of the following aspects of a medical history would the nurse expect to see with this client? (Select All that Apply.)

Choice A Reason:

Flumazenil is a benzodiazepine receptor antagonist used to reverse the effects of benzodiazepines like diazepam. It works by competitively inhibiting the action of benzodiazepines at the GABA receptor, thereby reversing sedation and other effects. Flumazenil is typically administered in cases of benzodiazepine overdose to counteract the sedative effects and restore normal respiratory function. However, it should be used cautiously as it can precipitate withdrawal and seizures in patients with long-term benzodiazepine use.

Choice B Reason:

Chlorpromazine is an antipsychotic medication primarily used to treat schizophrenia and other psychotic disorders. It is not indicated for the treatment of benzodiazepine overdose. Chlorpromazine works by blocking dopamine receptors in the brain, which helps to manage symptoms of psychosis but does not counteract the effects of benzodiazepines. Therefore, it would not be an appropriate choice in this scenario.

Choice C Reason:

Lithium carbonate is a mood stabilizer commonly used in the treatment of bipolar disorder. It helps to reduce the severity and frequency of mania and can also help to relieve or prevent bipolar depression. Lithium does not have any antagonistic effects on benzodiazepines and is not used in the treatment of benzodiazepine overdose. Thus, it would not be the correct medication to administer in this case.

Choice D Reason:

Methadone is a long-acting opioid used for pain management and as part of medication-assisted treatment for opioid use disorder. It works by binding to the same receptors in the brain as other opioids, helping to reduce withdrawal symptoms and cravings. Methadone does not counteract the effects of benzodiazepines and is not used in the treatment of benzodiazepine overdose. Therefore, it would not be an appropriate choice in this scenario.

Choice A Reason:

It is extremely important to maintain professional boundaries with clients.

Maintaining professional boundaries is crucial in nursing to ensure a therapeutic and trusting relationship between the nurse and the client. Crossing these boundaries can lead to ethical issues and compromise the care provided. In this scenario, the nurse allowed personal relationships to influence professional behavior, which is inappropriate and can undermine the client’s trust and the integrity of the nurse-client relationship.

Choice B Reason:

Countertransference may have been a factor in your actions with this client.

Countertransference occurs when a nurse’s personal feelings and experiences influence their professional interactions with a client. In this case, the nurse’s familiarity with the client as a childhood friend of a sibling may have led to biased actions, such as allowing the use of a personal mobile device and sharing confidential information. Recognizing and managing countertransference is essential to maintain objectivity and provide unbiased care.

Choice C Reason:

It would have been better if you called your sibling instead of texting.

This statement is not relevant to the primary issues at hand. Whether the nurse called or texted their sibling does not change the fact that sharing the client’s hospitalization status was a breach of confidentiality. The focus should be on the inappropriate disclosure of protected health information, not the method of communication.

Choice D Reason:

Policies can be amended for clients who are admitted voluntarily, not involuntarily.

This statement is incorrect. Policies regarding the use of personal mobile devices and confidentiality apply to all clients, regardless of whether they are admitted voluntarily or involuntarily. The nurse’s actions violated these policies, and the distinction between voluntary and involuntary admission does not justify the breach.

Choice E Reason:

You have violated HIPAA regulations by notifying your sibling of the client’s admission.

This is the correct response. The nurse violated HIPAA regulations by disclosing the client’s hospitalization status to their sibling without the client’s consent. HIPAA protects the privacy of individuals’ health information, and unauthorized disclosure is a serious violation that can result in legal and professional consequences.