A nurse is assisting with the admission of an older adult client who has impaired mobility and is at risk for falls. Which of the following actions should the nurse plan to perform first?

Answer: (D) A client has the right to view their medical record

Rationale:

A) The actual medical record belongs to the client: While clients have the right to access their medical records, the physical medical record itself typically belongs to the healthcare provider or facility that created it. The client does not own the physical document but has the right to view or obtain copies of it under HIPAA regulations.

B) A client's medical record information remains confidential, even during an emergency: While confidentiality is a core principle of the HIPAA Privacy Rule, there are specific exceptions during emergencies. For instance, healthcare providers may share information if it is necessary to provide care or if there is an imminent threat to the client or others. Thus, confidentiality can be adjusted in critical situations.

C) If the client dies, their family receives their medical record: A client’s medical records do not automatically go to their family after death. Access to a deceased person's medical records is typically granted to the executor of the estate or a legal representative, and specific legal processes must be followed. Therefore, this statement is incorrect.

D) A client has the right to view their medical record: Under the HIPAA Privacy Rule, clients have the right to access and view their medical records. They can request copies of their records, review them, and request amendments if they believe there are errors. This right is fundamental to ensuring transparency and accuracy in medical documentation.

Answer: B. Compare the result with the baseline reading

Rationale:

A. Check the client's heart rate on the oximeter:
Although checking the heart rate may provide context for assessing the client's overall status, it does not address the primary concern of the low oxygen saturation. Understanding the client's baseline saturation level takes priority to guide further actions effectively.

B. Compare the result with the baseline reading:
Comparing the reading with the client's baseline is essential. For clients with chronic respiratory conditions, baseline oxygen levels may naturally be lower. Identifying if this 88% saturation is typical or unusual for the client helps determine the need for further intervention or adjustment.

C. Decrease the amount of oxygen administered:
Reducing oxygen flow when the saturation is low is contraindicated, as it could worsen hypoxia. Instead, increasing oxygen may be warranted if the reading remains below the baseline after further assessment.

D. Perform another reading while the client ambulates:
Repeating the reading during ambulation may worsen hypoxia and is not ideal without understanding baseline oxygenation at rest. Re-evaluation at rest or in a different position may be more appropriate for accurate assessment.