Who should a nurse discuss concerns with if they witness a spouse potentially abusing a client?

When a nurse witnesses a potential abuse situation involving a client's spouse, it is crucial to prioritize the safety and well-being of the client. In this scenario, discussing concerns with Adult Protective Services (APS) is the most appropriate action. APS is specifically designed to investigate allegations of abuse, neglect, or exploitation of vulnerable adults, and they have the resources and expertise necessary to handle such situations sensitively and appropriately.

By reporting the concerns to Adult Protective Services, the nurse ensures that trained professionals can assess the situation, intervene if necessary, and provide the needed support to the client. This action aligns with the ethical responsibility of healthcare providers to protect vulnerable populations and take appropriate measures when there is a suspicion of abuse.

Engaging the client directly about the potential abuse may put them at further risk, especially if their spouse is the suspected abuser, and approaching the spouse could escalate the situation or violate confidentiality and trust. Communicating with the client's primary healthcare provider might be appropriate after reporting to APS, but the immediate action should focus on ensuring that the authorities equipped to handle abuse allegations are involved.