A practical nurse (PN) is assigned to care for a client who is scheduled for an elective surgical procedure in 30 minutes. The informed consent has already been signed, and the PN is preparing to administer the prescribed preoperative medications. The client suddenly becomes anxious and states, 'I have changed my mind. I do not want to have this surgery.' Arrange the following nursing actions in the correct order of priority from first to last.
- 1Withhold the administration of any preoperative medications and preparations.
- 2Ask open-ended questions to explore the client's feelings and confirm their intent to revoke consent.
- 3Notify the surgeon and the supervising registered nurse (RN) immediately regarding the client's decision.
- 4Remain with the client to provide emotional support while the surgeon explains the risks of refusing the procedure.
- 5Document the client's exact words, the time of refusal, and the personnel notified in the electronic health record.
Answer
The correct priority is to first withhold preoperative medications, then confirm the client's intent, notify the surgeon and RN, support the client while the surgeon explains the risks, and finally document the event.
When a client revokes informed consent, the immediate priority is to halt any interventions related to the procedure, such as giving preoperative medications. Next, the nurse clarifies the client's intent to ensure the refusal is definitive. Because it is outside the Practical Nurse's scope of practice to counsel the client on the medical risks of refusing surgery, the surgeon and supervising RN must be notified immediately. The Practical Nurse then remains to support the client while the surgeon provides the required medical explanations. Finally, detailed legal documentation is completed once the immediate situation is safely managed.
Step-by-Step Solution
Key Concept
When a client revokes informed consent, the Practical Nurse's priority is to immediately halt preparations, confirm the decision, and notify the provider, as explaining the medical risks of refusal is strictly within the provider's scope of practice.