Patient Data Following the visit, which action(s) should the nurse take? Select all that apply.
Explanation & Rationale
A. Document verbatim statements about the abuse: Recording the client’s exact words ensures accurate, objective documentation of the abuse. Verbatim documentation is essential for legal purposes, supports the client’s credibility, and provides clear evidence if future protective or legal actions are needed. B. Call the police as a mandatory reporter: In most jurisdictions, adult intimate partner violence is not a mandatory reportable condition unless there is immediate danger to the client or if children are involved. The nurse should respect the client’s autonomy while providing safety planning and resources, rather than automatically notifying law enforcement. C. Mail education items to the home for batterer treatment options: Sending materials to the client’s home may compromise safety, as the abusive partner could intercept them, increasing the risk of further harm. Education and referrals should be provided in person or through safe communication channels identified by the client. D. Provide referrals from the healthcare provider for mental health services: Referrals to mental health services, including counseling, support groups, or social work assistance, help the client process trauma, reduce psychological distress, and develop safety strategies. Access to professional support is an important intervention following disclosure of IPV. E. Follow up with the client in a few weeks: Scheduled follow-up allows ongoing assessment of safety, coping, and mental health. Regular check-ins provide opportunities to adjust care plans, reinforce safety strategies, and offer continued support, which is crucial in cases of ongoing or escalating intimate partner violence.