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Difficulty: HardLegal and Ethical Practice

A client is scheduled for a percutaneous endoscopic gastrostomy (PEG) tube placement. The gastroenterologist discussed the procedure with the client during morning rounds. When the practical nurse (PN) enters the room to witness the signature on the informed consent document, the client states, "The doctor said I need this feeding tube, but I really don't understand how it will affect my daily life and if I can ever eat normal food again." Which action is legally required of the PN?

  1. Halt the consent process and contact the gastroenterologist to provide further clarification to the client.Answer
  2. B
    Sit with the client and thoroughly explain the long-term lifestyle changes associated with a PEG tube.
  3. C
    Delegate the task of evaluating the client's procedural comprehension to the supervising registered nurse (RN).
  4. D
    Reassure the client that the procedure is routine and encourage them to sign the form to avoid delaying the surgery.

Answer

The legally required action is to halt the consent process and contact the gastroenterologist to provide further clarification to the client.
The correct action is to pause the consent process and notify the provider. For informed consent to be legally valid, the client must fully understand the procedure, including its risks, benefits, and expected outcomes. It is the legal responsibility of the provider performing the procedure to explain these details and address any questions. The nurse's role is strictly to witness that the signature is authentic, the client is competent, and the consent is voluntary. If the client has lingering questions, the nurse must serve as an advocate and halt the process until the provider clarifies.

Step-by-Step Solution

1
Identify the implications of the client's statement regarding the upcoming procedure.
The client's statement indicates a lack of understanding regarding the long-term effects of the surgery, meaning the criteria for informed consent have not been met.
Legally valid informed consent requires the client to fully comprehend the risks, benefits, and expected outcomes of the intervention.
2
Determine the scope of practice for the practical nurse (PN) regarding informed consent.
The PN's role is strictly limited to witnessing the voluntary signature of a competent client.
Legally, only the provider performing the procedure is authorized to explain the procedural details, risks, and alternatives.
3
Select the nursing intervention that upholds the law and advocates for the client.
The PN must stop the signing process and notify the provider to return and answer the client's questions.
This ensures the client receives accurate, legally sound information from the authorized practitioner before making a binding healthcare decision.

Key Concept

Informed Consent and PN Scope of Practice
Estimated Time:1m 15s
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Topics

Legal and Ethical Practice

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