Ethical and Legal Principles Flashcards
What is an ethical dilemma?
Situations that require individuals to make a choice between two equally unfavorable alternatives.
A nurse tells a patient they will come back in 30 minutes to check on their pain level. Within 30 minutes the nurse is back to assess the patient. What ethical principle did this nurse demonstrate?
Fidelity
Which of the following ethical principles refers to one’s duty to promote the good in others?
Autonomy
Beneficence
Nonmaleficence
Justice
Beneficence
A patient in the inpatient psychiatric facility has active orders for restraints due to aggression and agitation. The nurse checks on the patient every 15 minutes to ensure the restraints do not cause harm. What ethical principle does the nurse exhibit?
Nonmaleficence
What ethical principle emphasizes the rights of a patient to determine their destinies?
Autonomy
Legally, patient have the right to refuse treatment unless…
immediate intervention is required to prevent death or serious harm to patient or another person
Nurses can evaluate the patient’s _____ but not their _______.
capacity; competence
What is the right to least restrictive alternatives?
People have the right to whatever level of treatment is effective and least restricts their freedom.
Historically, people with mental illness were hospitalized against their will, when did this change for harmless individuals?
1976, Supreme Court ruled
A patient becomes increasingly agitated and begins to upset other patients on the unit. The nurse escorts the patient to a secluded area for de-escalation and redirection, these techniques fail and the nurse requests a secluded unit. This is an example of what ethical principle?
Justice
What does the ethical principle veracity refer to?
One’s duty to always be truthful.
Who must obtain the informed consent?
The provider
All patients have the right to care provided with respect, dignity, and without…
Discrimination
What are some examples on the level of least restrictive alternatives
Locked or unlocked unit
Inpatient or outpatient
Seclusion or restraints
HIPAA protects client confidentiality, when can a nurse legally break confidentiality?
Duty to Warn, Child Abuse, Vulnerable Adult Abuse
What is capacity vs. competence
Capacity: clinical determination of whether an individual is capable of making healthcare decisions
Competence: legal concept and is determined by a court
Name five elements of informed consent.
Patient’s role discussed
Diagnosis discussed
Proposed treatment discussed
Alternatives discussed
Risks and benefits of all options discussed
Probably course of recovery discussed
Patient/surrogate understanding assessed
Patient conveys preference
What is the least restrictive form of admission?
Informal admission
This type of admission is based on the client’s need for mental health treatment, risk of harm to self or others, or an inability to provide self-care.
Involuntary admission
What are the three Tort Law charges a nurse may face when willful actions damage a person’s property or violates their rights?
False imprisonment
Assault
Battery
What is the time limit on restraints for adults 18 years and older?
4 hours
The nurse must obtain a written order within 15-30 minutes if ___________ ___ of restraints is necessary.
emergency use
A patient has calmed down and expressed remorse for his behavior, the nurse removes his restraints. A few minutes later the same patient exhibits threatening behavior and the nurse reapplies the restraints. What is wrong with this tactic?
If seclusion/restraints are discontinued, the nurse needs to obtain a new order.
What other techniques can a nurse use before utilizing seclusion or restraints?
Verbal de-escalation
Redirection
Decreasing stimuli
Offering PRN medications
What is important to document when utilizing restraints or seclusion?
Client behavior - THE FACTS
Staff response
Time the provider was notified
Alternative actions taken
Time the restraints/seclusion was initiated
Current behavior
Medications administered
Vital signs
Signs of injury
Circulation / ROM
Proper application
