A nurse is reinforcing teaching with staff members about the protocol for extinguishing a fire in a trash can in a client's room. After removing the client from the room, which of the following actions should the nurse instruct the staff members to take next?

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) Sublingual medication is crushed and administered through a client's gastrostomy tube: This scenario represents a violation of the client's right to refuse treatment or medication. Administering medication through a route other than the one prescribed without the client's consent is inappropriate and can result in harm or adverse effects.

B) Finger nail marks appear on a client's wrist after a radial pulse was taken: This scenario indicates a violation of the client's right to be free from abuse. Evidence of physical harm, such as finger nail marks, suggests that the client may have been handled roughly or experienced unnecessary force during the procedure, which is unacceptable.

C) Pain medication is administered 1 hr before a client has a dressing change: While administering pain medication slightly ahead of a painful procedure may be appropriate to provide optimal pain relief, it does not inherently violate the client's rights if it aligns with the client's pain management plan and preferences. Therefore, this scenario does not represent a clear violation of client rights.

D) The same indwelling urinary catheter is reinserted after a failed attempt: Reinserting the same urinary catheter after a failed attempt could represent a violation of the client's right to safe care and freedom from unnecessary discomfort. Repeated attempts at catheter insertion without clinical justification increase the risk of infection and discomfort for the client.

E) Medications scheduled four times a day are administered 2 hr after the scheduled time: Administering medications significantly late violates the client's right to receive care in a timely manner. Delayed medication administration can affect treatment efficacy and compromise the client's well-being, especially for medications with strict dosing schedules.