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Zorluk: OrtaAdvance Directives and Informed Consent

A client is resting in a medical-surgical room awaiting a bedside thoracentesis. The physician has recently exited the room after discussing the intervention. The client holds the uncompleted paperwork and remarks to the practical nurse, "I am willing to sign this, but I am still very confused about those other treatment choices the doctor mentioned." Which of the following actions are appropriate for the nurse to perform? (Select all that apply.)

  1. Notify the physician that the client requires additional explanation regarding the alternative therapies.Cevap
  2. Refrain from witnessing the signature on the document until the client's questions have been fully answered.Cevap
  3. C
    Review the facility's educational materials with the client to clarify the differences between the treatments.
  4. D
    Assure the client that the physician would not recommend this intervention if it were not the absolute best choice.

Cevap

The appropriate actions are to refrain from witnessing the signature and to notify the physician.
Valid informed consent requires the client to fully comprehend the procedure and its alternatives. Because the practical nurse's role is strictly limited to witnessing the signature and confirming voluntary agreement, the nurse must advocate for the client by delaying the signing process and notifying the provider to return and clarify the medical information.

Adım Adım Çözüm

1
Identify the client's statement as a lack of full comprehension regarding the proposed procedure.
The client does not yet have the necessary understanding to provide valid informed consent.
Informed consent requires clear knowledge of risks, benefits, and alternatives before signing.
2
Determine the legal scope of practice for the practical nurse regarding informed consent.
The nurse is only authorized to witness the signature and verify voluntary agreement, not to explain medical details.
Explaining alternatives is solely the responsibility of the healthcare provider.
3
Select the nursing actions that protect the client's rights while remaining within the defined scope of practice.
The nurse must pause the consent process and escalate the issue to the provider.
This ensures the client receives accurate medical clarification from the authorized practitioner before signing.

Anahtar Kavram

The practical nurse's role in informed consent is limited to witnessing the signature and verifying voluntary, informed agreement. The nurse must not explain the procedure or alternatives, but instead notify the provider if the client has questions.
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