A client with a history of early-stage dementia is being admitted for an elective cardiac pacemaker insertion. During the admission assessment, the client is fully oriented and accurately explains the procedure, its purpose, and the surgical risks previously outlined by the cardiologist. The client's accompanying adult child reaches for the consent form, asserting that the client's dementia diagnosis automatically revokes their legal right to sign medical documents. Which action should the registered nurse take?
- Hand the consent form to the client to sign and act as the witness.Answer
- BAllow the adult child to sign the consent form to prevent potential legal liability.
- CAsk the adult child, 'Why do you feel your parent is incapable of making this decision?'
- DDelegate the responsibility of witnessing the consent signature to the unlicensed assistive personnel (UAP).
Answer
The nurse should allow the client to sign the consent form and act as the witness, because the client demonstrates the capacity to understand the procedure.
Competency for informed consent is based on the client's ability to understand the specific procedure, its risks, benefits, and alternatives at the exact time the consent is signed. A diagnosis of early-stage dementia does not automatically strip a client of their legal right to self-determination. Because this client is oriented and accurately describes the necessary elements of the surgery, they demonstrate the capacity to provide informed consent. The nurse must advocate for the client's autonomy and witness the signature.
Step-by-Step Solution
Key Concept
Informed Consent and Client Capacity
Estimated Time:1m 0s