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Difficulty: MediumInformed Consent

A client on a medical-surgical unit is preparing for an elective colonoscopy. The client, who has age-related hearing loss, is fully oriented. After the gastroenterologist explains the procedure and leaves the room, the nurse enters to witness the informed consent signature. The client hesitates and states, "I did not hear everything the doctor said. I am still confused about what happens if they find a growth." Which action by the nurse is required?

  1. A
    Direct an unlicensed assistive personnel to review the procedural pamphlet with the client before obtaining the signature.
  2. B
    Request that the client's next of kin sign the document, assuming the client's confusion represents expected cognitive decline.
  3. Notify the gastroenterologist that the client has unresolved questions and requires further clarification.Answer
  4. D
    Provide reassurance by stating, "Try not to worry; your doctor performs this routine procedure every single day."

Answer

Notify the gastroenterologist that the client has unresolved questions and requires further clarification.
The registered nurse's role in the informed consent process is to witness the signature, ensure the client is competent, and verify that the client fully understands the procedure. Because the provider is solely responsible for explaining the procedure, its risks, and alternatives, the nurse must notify the provider to return and clarify any remaining questions before the client signs the document.

Step-by-Step Solution

1
Assess the client's understanding of the planned procedure prior to witnessing the signature.
The client states they did not hear the provider and do not understand the potential interventions.
The nurse must verify that consent is informed, voluntary, and given by a competent individual.
2
Determine if the nurse can answer the client's questions within the registered nursing scope of practice.
The nurse recognizes that explaining procedural risks, benefits, and alternative outcomes is the responsibility of the healthcare provider.
Nurses may clarify basic nursing care but cannot provide the primary explanation for surgical or invasive medical procedures.
3
Intervene by halting the consent process and contacting the appropriate provider.
The gastroenterologist is notified to return to the bedside.
The client cannot legally consent until the provider ensures they fully hear and comprehend the procedure.

Key Concept

Informed Consent and Scope of Practice
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Topics

Informed Consent

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