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Difficulty: MediumAdvance Directives and Informed Consent

A client in a subacute rehabilitation facility is scheduled for a percutaneous endoscopic gastrostomy (PEG) tube placement. The provider has previously discussed the procedure with the client. When the practical nurse brings the consent form for a signature, the client asks, "I know how the tube works, but what are my other options if I refuse this surgery?" Which action should the practical nurse take first?

  1. Withhold the consent form and notify the provider to discuss alternative treatments with the client.Answer
  2. B
    Explain the various alternative methods for receiving nutrition, such as parenteral therapy.
  3. C
    Ask the registered nurse (RN) to answer the client's questions about alternative nutritional options.
  4. D
    Have the client sign the document and note their questions in the electronic health record.

Answer

Withhold the consent form and notify the provider to discuss alternative treatments with the client.
Informed consent requires the client to have a clear understanding of the procedure, its risks, benefits, and any alternative treatments. Explaining alternative treatments is strictly the responsibility of the healthcare provider. If a client has unanswered questions regarding alternatives, the practical nurse must act as an advocate by withholding the consent form and notifying the provider to return and speak with the client.

Step-by-Step Solution

1
Analyze the client's statement to identify what information is missing.
The client understands the procedure but is lacking information regarding alternative treatments.
Understanding risks, benefits, and alternatives is a fundamental legal requirement for informed consent.
2
Determine whose scope of practice covers providing information about alternative treatments.
Explaining procedures, risks, and alternatives is the sole responsibility of the healthcare provider performing the procedure.
The practical nurse's role is strictly limited to witnessing the signature and verifying that the consent is given voluntarily and competently.
3
Formulate the priority nursing action based on the scope of practice.
The nurse must stop the consent process and notify the provider to return and address the client's questions.
Advocating for the client's right to fully informed consent takes priority over obtaining a signature.

Key Concept

The practical nurse's role in informed consent is limited to witnessing the signature; answering questions about alternative treatments is the legal responsibility of the healthcare provider.
Estimated Time:1m 0s
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Topics

Advance Directives and Informed Consent

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