A nurse is preparing a client for surgery. The client expresses concern that someone might steal her purse during the procedure. Which of the following actions should the nurse take?

Choice A Reason:
Stating that the facility is unable to release the records, may not be accurate. Facilities typically have processes in place for releasing medical records upon request, although they may require written authorization.
Choice B Reason:
"You must submit a written request before you can receive a copy." This statement is correct. In most healthcare facilities, patients are required to submit a written request to obtain copies of their medical records. This process ensures that proper documentation is maintained and helps protect patient confidentiality and privacy. Additionally, providing medical records without proper authorization could violate healthcare privacy laws such as HIPAA (Health Insurance Portability and Accountability Act).
Choice C Reason:
Asking about the client's intentions with the medical record, is not appropriate as it could be seen as intrusive. Patients have the right to access their medical records for various purposes, and their intentions may not be relevant to fulfilling the request.
Choice D Reason:
Agreeing to make a copy of the medical records right away, is not the correct response without proper authorization. Making copies of medical records without following established procedures could lead to legal and ethical issues.

Choice A Reason:
White blood cell count (WBC) is incorrect. Melena, which is the passage of black, tarry stools, is typically associated with upper gastrointestinal bleeding rather than an infection. While changes in WBC count might occur in response to infection or inflammation, it is not the primary laboratory test to monitor in response to melena.
Choice B Reason:
Glucose is incorrect.
Glucose monitoring is important for assessing blood sugar levels, particularly in diabetic patients or those at risk of hypoglycemia or hyperglycemia. However, it is not directly related to the presence of melena, which indicates gastrointestinal bleeding.
Choice C Reason:
Blood urea nitrogen (BUN) is incorrect. Blood urea nitrogen (BUN) levels can indicate renal function and hydration status, but they are not specifically related to the presence of melena. Monitoring BUN may be relevant in other clinical contexts, such as assessing kidney function or dehydration, but it's not the primary laboratory test to monitor in response to melena.
Choice D Reason:
Hematocrit is correct. Melena indicates upper gastrointestinal bleeding, which can lead to a significant loss of blood. Monitoring the hematocrit level is crucial in this context because it helps assess the severity of bleeding and guide appropriate interventions such as blood transfusions if necessary. A decrease in hematocrit indicates a decrease in the volume of red blood cells, which reflects blood loss and the need for further evaluation and management.