Question

Management of Care:

Explain the legal responsibilities :

1. about advance directive,

2. caring for a client refused blood transfusion,

3. intervention within RN scope of practice

Answer 1

1. ADVANCE DIRECTIVE:

The advance directive include living will, health care proxies, and durable power of attorney for healthcare of a particular person. all should know the fact that advance directives can change at any time. the nurses or other healthcare providers will integrate the advance directives into the patients care plan. these advance directives are helpful to practioners to guide in the patients healthcare plan and in the treatments given at end of life. these also helpful in legal basis as the patient accept or reject the treatment as their wish. one should know about the complete information and alternative options from the healthcare organizations. the patient should know about the specific information about: patient self determination act, the uniform determination of death act, the uniform anatomical gift act, living wills, healthcare proxies and surrogates, durable power of attorney for healthcare.

2. CARING FOR A CLIENT REFUSED BLOOD TRANSFUSION:

Most of the people do not refuse blood transfusions but there are some people who belongs to the group of jehovah's witnesses they do not accept blood transfusions. for people like them many treatment care plans like meticulous medical management, use of prohaemostatic agents and some other techniques are used to decrease the blood loss. in extreme conditions the nurse or any healthcare professional should educate them to get blood transfusion. the JW'S use bible related words like 'everything that lives and moves will be food for u . just as i gave you the green plants, I now give you everything. however you must not eat meat that has its life blood still in it. Genesis 9:34". the physicians should respect the patients wish and they must treat them as the way they mentioned in the advance directive.

3. INTERVENTION WITHIN RN SCOPE OF PRACTICE:

The RN practice includes full scope of nursing and also includes care for all the patients in all the settings. the RN practice is independent and comprehensive. the registered nurse is governed by the nursing practice act, G.S. 90-171.20 (7). All levels of providers of nursing care will interprets the scope of practice. comparison with 21 NAC 36.0225 provides distinction from LPN scope of practice.the nursing practice is changing and enhanced day by day. it also introducing changes in the treatments and techniques used.RN practice is not defined by the specific activities or tasks but rather as a process consisting of legally defined set of components of practice using the steps of the nursing process . the components in the RN practice induce assessment, planning, implementation , evaluation, reporting and recording. collaborating, teaching and counselling. the interventions can be made by a nurse at any step  of their practice. the interventions made by a nurse can be divided into:

• intervention that lead to an entirely new intervention.
• adaption that modifies something already in existence.
• novel application of a intervention form one patient population to another.
• adoption of intervention into nursing practice that is used by another provider.