A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change-of-shift report?

Choice A Reason:
"Clients who participate in research studies forfeit their HIPAA right to privacy. "This statement is incorrect. While research studies may involve the use of personal health information, participants still retain their HIPAA rights to privacy. Research institutions are required to follow strict guidelines for protecting participants' privacy and confidentiality.
Choice B Reason:
"HIPAA prohibits the uploading of photographs of client's providers to social media sites. "This statement is true. HIPAA prohibits the unauthorized disclosure of protected health information (PHI), which includes photographs, on social media or any other public platform without the patient's explicit consent.
Choice C Reason:
"HIPAA allows facility-specific coding of client health care information to ensure privacy." This statement is ambiguous and could be interpreted in different ways. HIPAA requires covered entities to implement safeguards to protect the privacy of health information, which may include coding or encryption of data. However, facility-specific coding alone may not be sufficient to ensure privacy compliance without proper implementation of HIPAA privacy and security standards.
Choice D Reason:
"HIPAA allows clients to request a review of their own medical records. “This statement is correct. HIPAA grants individuals the right to access and review their own medical records held by covered entities, such as healthcare providers and health plans. This access allows patients to verify the accuracy of their medical information and understand how their health information is being used and disclosed.

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.