The medical-surgical nurse cares for a group of clients. Which client situations would prompt the nurse to notify the health care provider during the middle of the night? Select all that apply.

Question

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The nurse contacts the health care provider (HCP) for certain circumstances, regardless of the time of day. An emergent call is warranted if a client: Falls Deteriorates significantly or dies Has critical laboratory results Needs a prescription that requires clarification Leaves against medical advice or runs away Refuses key treatments in a relevant period The HCP should be called after the initiation of hospital protocols (eg, stroke, code blue) and after a concerning assessment finding (eg, significant change in vital signs, unilateral drift, change in level of consciousness, signs of trauma after a fall ) (Options A and B). Administration of heparin is normally discontinued prior to surgery due to the increased risk of bleeding and should be clarified with the HCP (Option C). A serum sodium of 124 mEq/L (124 mmol/L) (normal: 135-145 [135-145]) represents a critical value that can lead to altered mental status and seizures (Option D). (Option E) Clients have the right to refuse treatment; there is no indication that the client needs pain medication. With additional explanation, the client might reconsider if and when symptoms occur. Educational objective: The nurse should notify the health care provider, regardless of the time, for acute client deterioration (eg, neurological changes), critical laboratory values, falls, or death. Other reasons include prescription clarification and the client leaving against medical advice or refusing a key treatment.

The Medical-Surgical Nurse Cares for a Group of Clients