A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's death. Which of the following ethical principles should the nurse use to support the decision not to administer the medication?

A. "The oral medication you will take after this IV will dissolve the clot": This statement is incorrect. While anticoagulants like warfarin or direct oral anticoagulants (DOACs) may be prescribed to prevent the formation of new clots or to treat existing clots, heparin, whether administered intravenously or subcutaneously, is not typically used to dissolve existing clots.
B. "A pharmacist is the person to answer that question": This response deflects the client's question and does not provide useful information. While pharmacists are knowledgeable about medications, nurses are responsible for educating clients about their treatments and should be able to provide accurate information regarding heparin therapy.
C. "Heparin does not dissolve clots. It stops new clots from forming": This is the correct response. Heparin is an anticoagulant medication that works by inhibiting the formation of new clots rather than dissolving existing ones. It does so by inhibiting the activity of clotting factors in the blood, thus preventing the clot from enlarging or new clots from forming.
D. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level": While this statement provides information about the time required for heparin to achieve a therapeutic effect, it does not address the client's specific question about clot dissolution. Heparin's anticoagulant effects occur rapidly, but its primary action is prevention rather than dissolution of existing clots.

A. "HIPAA is a federal law, not a state law": This statement is correct. HIPAA, the Health Insurance Portability and Accountability Act, is a federal law enacted in 1996 to protect the privacy and security of individually identifiable health information. It applies nationwide and sets national standards for the protection of health information.
B. "HIPAA established regulations of individually identifiable health information in verbal, electronic, or written form": This statement is accurate. HIPAA regulations govern the privacy and security of protected health information (PHI) in various forms, including verbal, electronic, and written formats. The regulations apply to covered entities such as healthcare providers, health plans, and healthcare clearinghouses.
C. "Information about a client can be disclosed to family members at any time": This statement is incorrect. HIPAA regulations restrict the disclosure of protected health information (PHI) to third parties, including family members, without the patient's authorization, except in certain circumstances outlined in the law. While there are provisions for sharing PHI with family members involved in the patient's care, such disclosures typically require the patient's consent or may be permitted under specific exceptions, such as in emergency situations or when the patient is incapacitated.
D. "A client's address would be an example of personally identifiable information": This statement is accurate. Personally identifiable information (PII) under HIPAA includes any information that can be used to identify an individual, directly or indirectly, including names, addresses, dates of birth, social security numbers, and other demographic data. Therefore, a client's address would indeed be considered personally identifiable information under HIPAA.