Question

A female patient diagnosed with active tuberculosis wants to be discharged from the hospital after receiving one week of the required multiple drug regimen. Her condition has been improving and she is considered medically stable. The patient, her husband, and children recently immigrated to the United States from Bangladesh. They have no family or friends to assist them. Her husband recently started a job and needs her to come home to care for their 4-year-old twin boys or he will be fired.   

Craft an initial post that addresses:

What ethical concerns should the nurse consider?
What interventions need to be in place prior to discharge to prevent transmission of tuberculosis to her family and the public?
Provide a detailed education plan for discharge.

Answer 1

Q1

ANSWER: If the patient request to discharge without advice by the consult doctor then the nurse should consider ethical principle of autonomy and Leave against medical advice consent form. Principle of autonomy means the patient have the right to take her own decision regarding the treatment. The health care provider also should respect the decision. But in this situation, the nurse should take signature of the patient in the leaving against medical advice form. It is because as the discharge will be done base on the request by the patient, anything happen to the patient after discharge, it will be responsible by the patient self.

Q2

ANSWER: The intervention to be place prior to the discharge to prevent spreading of infection is health education regarding

1. Isolation: The patient should be isolated in her own room and not allow to contact with the low immunity people like old age and children. Advice to minimize the contact with her child as much as possible to prevent infection.

2. Treatment: The patient should complete the course of treatment which is advice by the doctor. Educate regarding the timing to consume the medication. Advice not to miss any dose. If miss the dose then it will not cure the disease instead it will make resistance of the organism to the drug.

3. Use of Personal protective measure: Before entering the room of the patient, all should use face mask and enter the room to prevent spreading. The patient also should use face mask most of the time to prevent spreading while coughing, sneezing,etc.

4. Handwashing: Proper handwashing should be done before and after touching the patient.