hard · NCLEX-RN Management of Care
A 48-year-old homeless client admitted with a chronic diabetic foot ulcer and suspected osteomyelitis refuses further IV antibiotic therapy and is leaving against medical advice (AMA). Which actions should the registered nurse (RN) take to support the client's safety? Select all that apply.
- Call the police to have the client arrested for self-neglect and placed on an involuntary psychiatric hold.
- Collaborate urgently with the provider on the safest disposition, which may include continued drainage with a portable one-way system; remove the tube only if clinical removal criteria are met.
- Inform the client of free community clinics and shelter-based healthcare services where they can receive ongoing wound care.
- Document the client's stated reasons for leaving and their understanding that refusing IV antibiotics could lead to amputation or sepsis.
- Provide the client with a supply of clean wound dressings and concrete written instructions on how to perform dressing changes.
- Review the prescriptions for oral antibiotics ordered by the provider as a harm-reduction alternative to IV therapy.
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