The patient's daughter requests to see the patient's medical record.
What is the nurse's appropriate response?

Choice A rationale

Sharing a password with the information system representative would violate security protocols. Passwords provide individual accountability and prevent unauthorized access to sensitive patient data. Allowing others access under your credentials compromises the system's integrity and audit trails, making it difficult to track actions and ensure data security.

Choice B rationale

Providing a password to the unit clerk would similarly breach confidentiality and security measures. Unit clerks may not have the same level of authorization or training regarding data privacy as nurses, increasing the risk of inappropriate access or misuse of patient information within the electronic health record.

Choice C rationale

Even sharing a password with the nurse manager is inappropriate. While the nurse manager is a supervisor, each individual user should have their own unique login credentials to maintain accountability and security. System access is granted based on individual roles and responsibilities, not shared passwords.

Choice D rationale

Maintaining the confidentiality of one's password is a fundamental principle of information security in healthcare. Each user is responsible for protecting their login credentials to prevent unauthorized access to patient records and ensure compliance with privacy regulations like HIPAA. This safeguards patient confidentiality and the integrity of the electronic health record.

Choice A rationale

Informing the patient that the urinary output goal was not met, without further investigation, does not address the underlying cause of the low output and fails to implement necessary interventions. It is a superficial action that lacks a scientific basis for improving the patient's condition.

Choice B rationale

Contacting the physician for a diuretic order without first assessing the cause of the reduced urinary output could be premature and potentially harmful. Diuretics increase urine production but may not be appropriate if the low output is due to dehydration, decreased renal perfusion, or other factors. Normal urine output is typically 0.5 to 1 mL/kg/hour.

Choice C rationale

Changing the goal to match the current inadequate output is inappropriate as it lowers the standard of care and fails to address a potentially serious underlying physiological issue. The initial goal of 80 mL/hour likely reflects the patient's needs based on their condition and weight.

Choice D rationale

Reassessing the patient is the most appropriate initial action. This allows the nurse to gather crucial data such as vital signs, hydration status, medication history, and any factors that might be contributing to the decreased urinary output. Understanding the cause is essential for implementing targeted and effective interventions.