Question

Difficulty: MediumAdvance Directives and Informed Consent

An emergency department practical nurse (PN) is caring for a client who requires an urgent chest tube insertion for a pneumothorax. The emergency provider explains the procedure, hands the consent form to the PN to obtain the signature, and steps out of the room to gather supplies. The client then asks the PN, "Will this tube completely fix my collapsed lung, or is there a chance it could happen again?" Which action should the PN take?

  1. A
    Reassure the client that the procedure is highly effective for a pneumothorax and witness the signature.
  2. B
    Ask the charge nurse to discuss the expected outcomes and risks of the procedure with the client.
  3. C
    Obtain the client's signature on the form and document in the chart that the client had additional questions.
  4. Inform the provider that the client has further questions about the procedure's outcomes before signing.Answer

Answer

The practical nurse should halt the signing process and inform the provider that the client requires further clarification about the procedure's expected outcomes.
The provider performing the procedure is legally responsible for explaining the risks, benefits, and expected outcomes. The practical nurse's role is solely to witness the signature and verify the client understands the information provided. If the client asks medical questions about the procedure itself, the PN must pause the signing process and notify the provider to return and clarify.

Step-by-Step Solution

1
Identify the PN's role in informed consent.
The PN's role is strictly limited to witnessing the client's signature and ensuring the client is signing voluntarily.
Nursing scope of practice dictates that nurses do not obtain the initial consent or explain the procedure's medical risks and benefits.
2
Evaluate the client's statement.
The client is asking a specific question about the expected medical outcome of the procedure ("Will this completely fix my collapsed lung?").
This indicates that the client does not have a complete understanding of the procedure, which invalidates informed consent.
3
Determine the appropriate intervention.
The PN must not allow the client to sign the form yet and must ask the provider to return to the room.
Only the healthcare provider performing the procedure is legally authorized to answer questions regarding surgical outcomes, risks, and alternatives.

Key Concept

The healthcare provider performing a procedure is solely responsible for explaining its risks, benefits, and expected outcomes; the nurse's role is to witness the signature and notify the provider if the client has lingering questions.
Estimated Time:1m 0s
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