A client on a cardiac step-down unit is scheduled for the insertion of a permanent pacemaker. When the practical nurse prepares to witness the signature on the informed consent document, the client states, "I remember the doctor explaining things, but I am still not sure if this device will shock me if my heart stops." Which action should the practical nurse take?
- AWitness the client's signature and document in the health record that the client had remaining questions.
- BProvide a facility-approved educational pamphlet about the pacemaker procedure and return later to witness the signature.
- Inform the healthcare provider that the client requires further clarification before signing.Answer
- DClarify for the client that an implantable cardioverter-defibrillator delivers shocks, whereas a pacemaker regulates a slow rhythm.
Answer
Inform the healthcare provider that the client requires further clarification before signing.
Informed consent requires that the client fully understands the procedure, its risks, benefits, and alternatives. The practical nurse's role is strictly limited to witnessing the signature and ensuring the client is signing voluntarily. If a client expresses confusion or asks questions about the medical details of the procedure, the nurse must halt the signing process and notify the healthcare provider. It is the provider's legal obligation to explain the procedure and resolve any misunderstandings before consent is finalized.
Step-by-Step Solution
Key Concept
Advance Directives and Informed Consent