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Difficulty: MediumAdvance Directives and Informed Consent

Prior to an elective hernia repair, a client who has already signed the surgical consent form suddenly states to the practical nurse (PN), "I have changed my mind. I do not want to go through with this operation today." Which action should the PN take first?

  1. Notify the operating surgeon and the charge nurse immediately regarding the client's decision.Answer
  2. B
    Explain the potential health complications that may occur if the hernia is left untreated.
  3. C
    Ask the client why they are suddenly refusing the procedure after already agreeing to it.
  4. D
    Independently cancel the surgical procedure order in the electronic health record.

Answer

Notify the operating surgeon and the charge nurse immediately regarding the client's decision.
Clients retain the legal and ethical right to withdraw informed consent at any time prior to the initiation of a procedure, regardless of having previously signed a consent form. When a client revokes consent, the immediate priority for the practical nurse is to communicate this critical information to the healthcare provider and the charge nurse so that surgical preparations are halted and the provider can appropriately discuss the decision with the client.

Step-by-Step Solution

1
Recognize that a client has the absolute right to revoke informed consent at any point before a procedure begins.
The PN identifies that the client's statement constitutes a legal withdrawal of consent.
Informed consent is an ongoing, voluntary process, not simply the act of signing a physical document.
2
Determine the boundaries of the PN scope of practice in this specific scenario.
The PN acknowledges that discussing the medical risks of refusal or altering procedure orders is the provider's responsibility.
The PN's legal role is to advocate for the client and communicate critical changes in status to the healthcare team.
3
Prioritize the immediate next step to ensure client safety and honor their legal rights.
The PN selects the action to immediately escalate the client's decision to the operating surgeon and charge nurse.
The surgical team must be alerted immediately to halt preoperative preparations and allow the provider to speak directly with the client.

Key Concept

A client has the right to revoke informed consent at any time, and the practical nurse's priority is to immediately notify the healthcare provider of this change without attempting to educate on medical risks.
Estimated Time:1m 0s
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Topics

Advance Directives and Informed Consent

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