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Difficulty: HardEthical Practice

During a shift on a surgical unit, a nurse receives a radiology report indicating that a small, sterile surgical sponge was inadvertently left inside a client's abdominal cavity during a procedure performed the previous day. The client is alert, oriented, and recovering well. The attending surgeon approaches the nurse and states, 'I will schedule the client for a brief wound washout today to retrieve the sponge. Please do not mention the retained sponge to the client; knowing about this error will only cause unnecessary panic, and I can resolve it safely.' Which of the following responses or actions by the nurse most appropriately upholds the ethical principles of veracity and client advocacy?

  1. Express to the surgeon that the client must be fully informed about the specific complication before providing consent for the secondary procedure.Answer
  2. B
    Provide reassurance to the client that secondary surgical washouts are a routine and expected phase of the abdominal healing process.
  3. C
    Focus on rapidly preparing the client for the operating room to minimize the physiological risk of a systemic infection.
  4. D
    Agree to temporarily withhold the clinical findings to prevent acute distress, and submit an anonymous incident report after the surgery concludes.

Answer

Express to the surgeon that the client must be fully informed about the specific complication before providing consent for the secondary procedure.
The correct answer demonstrates the nurse's role as a client advocate. Veracity is the ethical principle of telling the truth. Autonomy refers to the client's right to self-determination. For a client to exercise autonomy through informed consent, they must be truthfully informed about their condition, the proposed procedure, and the reasons for it. The surgeon's request to hide the retained sponge represents paternalism and violates the client's rights. The nurse must firmly advocate for the client's right to full disclosure before allowing the secondary procedure to proceed.

Step-by-Step Solution

1
Identify the ethical dilemma presented in the scenario.
The conflict is between the surgeon's directive to withhold truth (paternalism) and the client's right to know the truth (veracity) and make informed decisions (autonomy).
Recognizing the competing ethical principles is the first step in ethical decision-making.
2
Determine the nurse's primary ethical and legal obligation.
The nurse's primary duty is to act as a client advocate, ensuring the client receives truthful information necessary for valid informed consent.
The ANA Code of Ethics mandates that nurses protect the health, safety, and rights of the client.
3
Select the intervention that directly addresses the ethical obligation without compromising the client's rights.
The nurse must confront the surgeon's plan to deceive the client and advocate for full disclosure prior to the procedure.
Active advocacy is required when a client's right to autonomy and informed consent is threatened by another healthcare team member.

Key Concept

Ethical Principles: Veracity, Autonomy, and Informed Consent
Estimated Time:1m 30s
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Topics

Ethical Practice

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