A client is in the preoperative holding area preparing for an elective laparoscopic cholecystectomy. The client has not yet received any preoperative sedatives. When the registered nurse approaches to witness the signature on the informed consent form, the client withdraws their hand and states, "I am too frightened. I do not think I want to go through with this operation today." Arrange the following nursing actions in the correct order of priority from first to last.
- 1Cease all further preoperative preparation activities.
- 2Explore the client's specific fears and concerns using therapeutic communication.
- 3Contact the operating surgeon to speak directly with the client.
- 4Notify the operating room charge nurse of the potential delay.
- 5Document the client's statements and the provider notifications in the medical record.
Answer
The correct sequence is to first cease preoperative preparation, then explore the client's concerns, contact the operating surgeon, notify the operating room charge nurse, and finally document the event.
When a client expresses hesitation or revokes consent, the nurse must first stop any related procedures to protect the client's right to self-determination. Next, following the nursing process, the nurse assesses the situation by exploring the client's concerns. Third, the nurse acts as an advocate by contacting the provider, as addressing surgical risks or alternatives is the provider's legal responsibility. Fourth, the nurse coordinates care by updating the operating room charge nurse about the delay. Finally, after the clinical situation is managed, the nurse documents the client's exact statements and the actions taken to ensure a legally accurate medical record.
Step-by-Step Solution
Key Concept
The registered nurse advocates for the client's right to refuse treatment by halting procedures, assessing concerns, and notifying the provider to address questions that fall outside the nursing scope of practice.