The "independent action" performed by a nurse that is administratively acceptable is when she:

GMCH - 2016

Fundamental of Nursing

Medium

Appeared in: GMCH - 2016

Explanation

Giving cold sponging to a febrile patient is an independent nursing action aimed at providing comfort and managing a symptom (fever).
According to nursing fundamentals, independent interventions are autonomous actions based on scientific rationale that a nurse can initiate without a physician's order.
This action falls within the scope of nursing practice related to providing comfort, promoting hygiene, and managing activities of daily living.
The key differentiator is that this action does not involve prescribing medication, making a medical diagnosis, or altering the primary treatment plan, which require a physician's order.

Option A: Administering Morphine, a controlled narcotic, is a dependent nursing action. It requires a specific prescription and order from a licensed physician.
Option B: Discharging a patient is a formal process that requires a physician's order. A nurse cannot independently decide to discharge a patient, even on request. This is an interdependent or collaborative action.
Option D: Ordering diagnostic tests like an ultrasound is a dependent action. This falls under the purview of medical diagnosis and must be initiated by a physician or another qualified provider.

Clinical Relevance

Nursing practice connection: Knowing Scope of Nursing Practice: Independent vs. Dependent Actions helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Understanding the scope of practice is a fundamental legal and ethical responsibility for every nurse. It ensures patient safety by preventing nurses from performing tasks for which they are not authorized.
Acting within one's scope of practice protects the nurse from liability and upholds the professional standards of nursing.
What if? If a patient with a fever is a neonate or has a history of febrile seizures, the nurse can still independently provide tepid sponging. However, the situation's urgency requires an immediate interdependent action: notifying the physician for further dependent orders (e.g., antipyretics, blood cultures), as fever in this population is a critical sign.

How to Approach the Question

First, identify and define the key concept in the question stem, which is 'independent action' for a nurse.
Recall that an independent action is one a nurse can perform using their own judgment and expertise, without a doctor's order.
Systematically evaluate each option against this definition.
Analyze Option A: Administering morphine is administering a drug, which always requires a prescription (dependent action).
Analyze Option B: Discharging a patient is a formal medical and legal process requiring a doctor's order (dependent/interdependent action).
Analyze Option D: Ordering a diagnostic test is part of making a medical diagnosis, which is a doctor's role (dependent action).

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 27-29

E6 Nursing Fundamentals Taylor p. 428-430