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Difficulty: MediumAdvance Directives and Informed Consent

A client at 38 weeks gestation is admitted to the maternal-newborn unit for a scheduled cesarean birth. The obstetrician has discussed the procedure with the client, and the practical nurse (PN) subsequently brings the consent form for the client to sign. While holding the pen, the client states, "I know we talked about this, but I am still unclear about what complications this might cause for my baby." Which action is the priority for the PN to take?

  1. Stop the consent process and notify the obstetrician that the client has further questions about the risks.Answer
  2. B
    Review the potential fetal complications of a cesarean birth based on the unit's educational materials.
  3. C
    Reassure the client that the obstetrician is highly experienced and would only recommend what is safest.
  4. D
    Instruct the client to sign the form now and write their questions down to ask the surgical team later.

Answer

The priority action is to stop the consent process and notify the obstetrician that the client has further questions about the risks.
The role of the practical nurse (PN) in informed consent is to witness the client's signature and ensure the client is signing voluntarily and with full understanding. Explaining the risks, benefits, and alternatives of a procedure is strictly the responsibility of the healthcare provider. When a client expresses confusion or asks direct questions about the procedure's risks, the PN must halt the consent process and notify the provider to return and clarify, ensuring the consent is legally sound and truly informed.

Step-by-Step Solution

1
Identify the client's statement regarding the surgical procedure.
The client explicitly states they are unclear about the complications the surgery might cause for the baby.
This statement indicates a lack of full understanding, meaning the consent is not yet truly informed.
2
Determine the scope of practice for the practical nurse (PN) regarding informed consent.
The PN's role is strictly limited to witnessing the signature and verifying voluntary agreement, not explaining the risks or benefits.
Explaining the risks, benefits, and alternatives is legally the sole responsibility of the healthcare provider performing the procedure.
3
Select the appropriate nursing intervention based on the established scope of practice.
The PN must halt the consent process and contact the obstetrician to address the client's questions.
This action ensures the provider fulfills their legal duty and guarantees the client is fully informed before legally consenting to the surgery.

Key Concept

Advance Directives and Informed Consent
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Topics

Advance Directives and Informed Consent

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