A nurse is preparing to provide change-of-shift report. Using the SBAR communication technique, which of the following client information should the nurse include in the "A" portion of the report?

A) Ask the provider to give consent for the transfusion:

The provider cannot override the decision made by the client's designated healthcare proxy. Even if the provider were to give consent for the transfusion, it would not be ethically or legally appropriate to proceed with the treatment against the expressed wishes of the client's healthcare proxy.

B) Discuss taking guardianship of the client with the facility administration:

Seeking guardianship of the client would be an extreme measure and may not be necessary or appropriate in this situation. Guardianship is typically pursued when there are concerns about an individual's capacity to make decisions for themselves and when there is no designated healthcare proxy available to make decisions on their behalf. In this case, the client has a designated healthcare proxy, and it is more appropriate to respect the daughter's decision as the client's authorized representative.

C) Respect the daughter's decision to refuse the transfusion:

In situations where a client has designated a durable power of attorney for healthcare, the individual designated as the healthcare proxy has the legal authority to make healthcare decisions on behalf of the client, including the refusal of treatment. In this case, the daughter, acting as the client's healthcare proxy, has refused the blood transfusion for her mother. It is important for the nurse to respect and honor the daughter's decision, as it aligns with the client's previously documented wishes.

D) Encourage the daughter to let her mother have the transfusion:

While it is understandable that the nurse may want to advocate for the client's well-being, in this situation, the daughter's decision as the client's healthcare proxy must be respected. Encouraging the daughter to change her decision would not be appropriate if it goes against her understanding of what is in her mother's best interests and the client's previously documented wishes.

A) Initiate oxygen therapy via nasal cannula for a client who has COPD:

Clients with chronic obstructive pulmonary disease (COPD) often have impaired gas exchange and may experience acute exacerbations requiring oxygen therapy to improve oxygenation and alleviate respiratory distress. Oxygen therapy is a critical intervention to address hypoxemia and prevent complications such as respiratory failure. Therefore, initiating oxygen therapy for a client with COPD is the highest priority among the options provided.

B) Initiate a 24-hr urine collection for a client who has end-stage kidney disease:

Initiating a 24-hour urine collection is an important nursing task for clients with end-stage kidney disease to monitor renal function and assess urine output. However, compared to the immediate need for oxygen therapy in a client with COPD, starting a urine collection is a lower priority and can be scheduled once the client's respiratory needs are addressed.

C) Administer an antibiotic for a client who has methicillin-resistant Staphylococcus aureus:

Administering antibiotics for a client with methicillin-resistant Staphylococcus aureus (MRSA) infection is important to control the spread of infection and prevent complications. However, unless the client's condition is critically unstable or the antibiotic administration is time-sensitive, addressing oxygenation needs for a client with COPD takes precedence due to the potential for respiratory compromise and hypoxemia.

D) Change the dressing for a client who has a decubitus ulcer:

Changing dressings for clients with decubitus ulcers is essential for wound care management and prevention of infection. While maintaining skin integrity is important, addressing respiratory distress in a client with COPD is a higher priority to ensure adequate oxygenation and prevent respiratory compromise.