A nurse is caring for a client who is scheduled for an elective laparoscopic cholecystectomy in 2 hours. The client received an intravenous dose of morphine sulfate 30 minutes ago for severe biliary colic. The surgeon enters the room, explains the risks, benefits, and alternatives of the surgery, and leaves. The client, who is drowsy but awakens easily and is oriented to person, place, and time, states, "I understand everything the doctor said. Give me the pen so I can sign the consent form." Which of the following is the priority nursing action?
- Withhold the consent form and notify the surgeon that the client cannot legally sign due to recent opioid administration.Answer
- BWitness the client's signature, as the client is currently awake, oriented, and able to verbalize understanding of the procedure.
- CRequest that the client's spouse, who is present in the room, sign the consent form on the client's behalf.
- DReassure the client that verbal consent is legally sufficient for this procedure and document the interaction in the medical record.
Answer
The priority action is to withhold the consent form and notify the surgeon that the client cannot legally sign due to recent opioid administration.
The correct action is to withhold the consent form and notify the surgeon. For informed consent to be legally valid, the client must be competent. A client who has received a central nervous system depressant (such as intravenous morphine) within the previous several hours is considered temporarily legally incompetent, regardless of their apparent orientation. Since this is an elective procedure, it must be delayed until the medication's effects have completely resolved.
Step-by-Step Solution
Key Concept
Legal Competency for Informed Consent