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Question: Chris, a registered nurse (RN), arrives for work on the day shift on an acute care medical unit a…

Chris, a registered nurse (RN), arrives for work on an acute care medical unit on the day shift and is given a patient assignment for the shift. The task entails caring for five medical patients. The nurse makes rounds on the five patients after receiving the night shift report, performing a head-to-toe examination of each, listing each patient’s concerns, setting patient goals, and planning their treatment for the day. During the shift Chris administers intravenous (IV) medications to all five patients; ensures that all oral medications are given by the licensed practical nurse (LPN); asks the unlicensed assistive personnel (UAP) to bathe two of the patients who need assistance; assists a patient with ambulation; provides education to a patient who will be discharged on a new medication; evaluates the plan of care for each patient, with updates as necessary; and notifies the primary care providers of critically abnormal blood work results for two patients. When a friend of one of the patients comes to visit, Chris stops him in the corridor and asks specific questions about the patient’s condition. Patient information is protected, according to Chris, and cannot be released without the patient’s agreement. At a recent continuing education conference, Chris learned that current evidence showed that aspirating the syringe after the needle is inserted into the muscle before administering deltoid intramuscular (IM) injections was no longer recommended. He recalls this new information as he prepares to administer an IM vaccine to a patient before discharge. Chris believes that self-care promotes wholeness and that it can be met by doing for, directing, teaching, encouraging, or creating the atmosphere for patients to practice self-care. Discussion topics include the following: Which of the nurse’s duties does Chris play, and when did he play them? Which of Chris’ acts are in compliance with HIPPA? During the shift, which of the ANA standards of nursing practice is Chris demonstrating?