A practical nurse (PN) is caring for a client who is scheduled for a cardiac catheterization. As the PN is preparing the insertion site, the client suddenly pulls away and states, "I changed my mind. I don't want anyone putting a tube in my heart. I am not doing this." Arrange the following actions the PN should take in the correct order of priority from first to last.
- 1Stop the physical preparation for the procedure immediately.
- 2Acknowledge the client's right to refuse the treatment.
- 3Explore the client's concerns using open-ended questions.
- 4Notify the healthcare provider and the charge nurse of the refusal.
- 5Document the client's statement and the notification of the provider.
Answer
The correct sequence is to first stop the physical preparation, then acknowledge the client's right to refuse, explore their concerns, notify the healthcare provider and charge nurse, and finally document the event.
When a client withdraws consent, the practical nurse must follow a logical sequence based on the nursing process and safety prioritization. Safety and honoring autonomy come first, meaning all preparation must stop immediately. Next, acknowledging the client's right to refuse builds trust, which facilitates the data collection phase (exploring concerns). Once data is gathered, the nurse acts as an advocate by communicating the situation to the healthcare provider. Finally, the nurse legally protects all parties by documenting the sequence of events.
Step-by-Step Solution
Key Concept
Client Autonomy and the Right to Refuse Treatment