The nurse is caring for a 4-year-old child in the emergency department who has a 104 F (40 C) temperature, is obtunded, and has a positive Kernig's sign. The parents are refusing antibiotics and any treatment. The parents state that their religious belief is to trust in just prayer and believe the child will receive divine healing. What action does the nurse anticipate?

Question

The nurse is caring for a 4-year-old child in the emergency department who has a 104 F (40 C) temperature, is obtunded, and has a positive Kernig's sign.  The parents are refusing antibiotics and any treatment.  The parents state that their religious belief is to trust in just prayer and believe the child will receive divine healing.  What action does the nurse anticipate?

Quizplus · Accepted Answer

A competent adult has the right to make any decision regarding the client's health care even if the provider does not believe it is in the client's best interest. However, parents do not have the right to place their minor child in a life-threatening position. Parents have legal authority to make choices about their child's health care, but not when they do not permit life-saving treatment or when there is a potential conflict of interest, such as child abuse or neglect. The hospital will seek court-appointed custody to treat this child who is seriously ill with dangerously high temperature and signs of severe neurologic deficit. Bacterial meningitis presents with high fever, change in level of consciousness, nuchal rigidity, and meningeal signs (positive Kernig's and Brudzinski's signs). Antibiotic treatment is essential. (Option A) The parents will not be allowed to take this child out of the hospital against medical advice as it will endanger the child's life. It does not matter that it is a religious reason for the desired AMA. (Option B) Durable power of attorney for health care (health care proxy) is something a competent adult establishes when that adult can no longer self-advocate. Parents are automatically the legal guardians and decision makers for their minor children as long as the decisions do not put any of their children in danger. (Option D) The ethical principle of autonomy is deciding for oneself. In this case, the child's best interest is priority and the legal authority takes precedent. Educational objective: Hospital administration will obtain legal protective custody of a minor child if the parents are deciding against life-saving measures for their child or when there is child abuse/neglect.

The Nurse Is Caring for a 4-Year-Old Child in the Emergency