A client in the preoperative holding area of an ambulatory care center is scheduled for an elective lithotripsy. After the surgeon has explained the procedure and left the area, the client tells the practical nurse (PN), "I changed my mind. I am too scared and do not want to go through with this surgery." In what order should the PN perform the following actions? (Arrange from first action to last action)
- 1Acknowledge the client's concerns and confirm their decision to withdraw consent.
- 2Halt all preoperative preparations and withhold any prescribed preprocedural sedatives.
- 3Notify the surgeon and the supervising registered nurse about the client's decision.
- 4Document the client's exact statement and the personnel notified in the medical record.
Answer
The correct sequence is to first confirm the client's decision, then ensure safety by stopping preoperative preparations, followed by notifying the appropriate providers, and finally documenting the event.
When a client revokes informed consent, the nursing process guides the PN's prioritization. First, the PN must assess and confirm the client's statement to ensure clear communication. Second, the PN must immediately implement safety measures by halting any procedures or medications (such as sedatives) related to the canceled surgery, as administering them would constitute battery. Third, the PN must notify the RN and the surgeon, as it is the provider's responsibility to discuss the risks of refusing the procedure and formally cancel the medical orders. Finally, after all immediate actions and notifications are complete, the PN documents the entire event objectively in the medical record.
Step-by-Step Solution
Key Concept
Informed Consent Revocation and PN Scope of Practice