A practical nurse (PN) is preparing to administer a prescribed preoperative sedative to a competent adult client scheduled for an elective surgery. The client suddenly states, "I have changed my mind. I do not want to go through with this surgery anymore." Arrange the following nursing actions in the priority order the PN should perform them. (Place the first action at the top and the last action at the bottom.)
- 1Withhold the preoperative sedative and halt further surgical preparation.
- 2Affirm the client's right to refuse the procedure to establish a supportive environment.
- 3Explore the client's specific concerns or reasons for refusing the surgery.
- 4Notify the charge nurse and the primary healthcare provider of the client's decision.
- 5Document the client's refusal, withheld medication, and provider notification in the health record.
Answer
The correct priority sequence is to first withhold the medication, then affirm the client's right to refuse, explore their concerns, notify the provider, and finally document the event.
When a client refuses treatment, the priority is to immediately stop the intervention to uphold their autonomy and prevent battery. The nurse then acts as an advocate by validating their decision and exploring their concerns to gather necessary data. Following data collection, the nurse reports the situation to the healthcare provider, who is responsible for explaining the medical consequences of the refusal. Finally, the nurse documents the entire event objectively in the medical record to ensure legal compliance and continuity of care.
Step-by-Step Solution
Key Concept
Client autonomy and the right to refuse treatment