A nurse is caring for a client who is at the end of life. Which of the following interventions is most effective in reducing the client's social isolation?

Explanation:

A. "We use an automated dispensing device to track the use of controlled substances."

This is a valid statement. Automated dispensing devices (ADDs) help track the use of controlled substances by requiring users to log in, record transactions, and provide an audit trail of medication access.

B. "You are required to have a second nurse witness disposal of a controlled substance."

Having a second nurse witness disposal of controlled substances is a common practice to ensure accountability and prevent diversion. This statement aligns with safety protocols.

C. “If a client refuses a medication, you can place it in your pocket to administer later."

This statement is incorrect and potentially dangerous. Controlled substances should never be pocketed or carried around for later administration, as this increases the risk of diversion and compromises medication safety.

D. "Activities of the automated dispensing machine will be reviewed periodically."

Reviewing the activities of the automated dispensing machine is an essential part of medication safety and helps detect any discrepancies or irregularities in medication access and administration.

E. "We count the amount of a controlled substance available before removal from a medication drawer."

Counting the amount of controlled substances before removal from a medication drawer is a standard procedure to ensure accurate inventory management and detect any discrepancies or losses promptly.

Explanation:

A. Whisper to the patient that she will be saved.

This action is inappropriate and does not address the underlying issues of the patient's condition or the presence of the family friend. Whispering such a statement may also be confusing or alarming to the patient.

B. Confront the family friend to allow the patient to ask questions.

While it's important to facilitate open communication with the patient, confronting the family friend directly may not be the most effective approach initially. It's crucial to first assess the patient's comfort level and safety before addressing the situation with the friend.

C. Consult the healthcare team about the suspicions and call local authorities to investigate.

Jumping to conclusions and involving authorities without gathering more information or assessing the patient's feelings directly could escalate the situation unnecessarily. It's important to handle such concerns with sensitivity and professionalism, involving appropriate resources only when needed.

D. Ask the patient if she feels safe, while the friend is in the room.

This is the most appropriate action initially. By directly asking the patient about her feelings of safety, the nurse can gauge the patient's comfort level and assess any potential concerns or risks. This approach allows the nurse to gather information and address any issues in a supportive and patient-centered manner. If the patient expresses concerns or discomfort, further assessment and appropriate interventions can be implemented, which may include involving other members of the healthcare team or authorities if necessary.