A gerontological nurse in a long-term care facility is implementing practices to provide quality, cost-effective care. Which action would be appropriate for the nurse?

A. The client requires transfusions of packed red blood cells during care.

In Judaism, blood transfusions are generally accepted as a medical intervention to save a life or improve health. However, opinions may vary among individuals and communities. It's essential to respect the client's wishes regarding medical interventions, including blood transfusions, and to involve the family in decision-making if necessary. While this intervention may not inherently conflict with Jewish beliefs, individual preferences and religious interpretations should be respected.

B. Assessment by a male health care provider was required.

In Orthodox Judaism, there are rules regarding modesty and gender separation, particularly concerning physical contact with members of the opposite sex. Some Orthodox Jewish women may prefer female healthcare providers, especially for intimate examinations or procedures. It's crucial to respect the client's religious beliefs and preferences regarding modesty and gender-related care.

C. A do-not-resuscitate (DNR) order was recommended by the care team.

End-of-life decisions, including DNR orders, can be complex and sensitive topics in Judaism. While some Jewish individuals may choose to have a DNR order based on their beliefs about the sanctity of life and quality of life, others may prefer all possible measures to be taken to prolong life. It's essential to involve the client, their family, and potentially a spiritual advisor or rabbi in discussions about end-of-life care preferences and decisions.

D. An autopsy was ordered due to the client's unique disease etiology.

Autopsies are generally discouraged in Judaism because they are viewed as desecrating the body and delaying burial, which is an important aspect of Jewish tradition. However, there may be exceptions in certain circumstances, such as when required by law or when necessary for medical research or legal reasons. Nevertheless, sensitivity to the religious beliefs and practices of the client and their family is crucial when considering autopsy requests.

A. "Provided you signed a directive on admission, your records will not be made public."

While signing a directive may be part of the admission process, confidentiality is not contingent solely on this. The statement may give the impression that the client's privacy depends on a specific action they took, which is not entirely accurate. Privacy is protected by law regardless of whether a directive was signed.

B. "Privacy legislation ensures that your medical records will not leave this hospital."

Privacy legislation (such as HIPAA in the U.S.) does protect a client's health information, but the statement that records "will not leave this hospital" could be misleading. Records can be shared within the healthcare system or with others involved in the client's care, with the client's consent. This option may oversimplify the scope of privacy protection.

C. "The law protects your right to confidentiality and health information from being released into unintended hands."

This is an accurate and appropriate response. It acknowledges the client's concern and reassures them that the law protects their confidentiality, emphasizing that their health information will not be shared inappropriately.

D. "Anything that is discussed between us is confidential and will not be shared with anyone else."

While this statement reassures the client, it is not entirely accurate. Some information may need to be shared with other healthcare providers involved in the client's care, or in situations required by law (e.g., public health reporting, certain legal proceedings). The statement could be misleading by implying absolute confidentiality, which is not the case.