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Zorluk: OrtaClient Rights and Advocacy

A practical nurse (PN) is caring for a client who is scheduled for a cardiac catheterization. As the PN is preparing the insertion site, the client suddenly pulls away and states, "I changed my mind. I don't want anyone putting a tube in my heart. I am not doing this." Arrange the following actions the PN should take in the correct order of priority from first to last.

  1. 1Stop the physical preparation for the procedure immediately.
  2. 2Acknowledge the client's right to refuse the treatment.
  3. 3Explore the client's concerns using open-ended questions.
  4. 4Notify the healthcare provider and the charge nurse of the refusal.
  5. 5Document the client's statement and the notification of the provider.

Cevap

The correct sequence is to first stop the physical preparation, then acknowledge the client's right to refuse, explore their concerns, notify the healthcare provider and charge nurse, and finally document the event.
When a client withdraws consent, the practical nurse must follow a logical sequence based on the nursing process and safety prioritization. Safety and honoring autonomy come first, meaning all preparation must stop immediately. Next, acknowledging the client's right to refuse builds trust, which facilitates the data collection phase (exploring concerns). Once data is gathered, the nurse acts as an advocate by communicating the situation to the healthcare provider. Finally, the nurse legally protects all parties by documenting the sequence of events.

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1
Prioritize client safety and autonomy by halting the procedure preparation.
The physical preparation is immediately stopped.
Continuing to prepare a client who has explicitly withdrawn consent violates their legal rights and constitutes battery.
2
Support the client's decision.
The nurse acknowledges the client's right to refuse.
This action validates the client's autonomy and builds therapeutic trust during a potentially stressful moment.
3
Collect data regarding the refusal.
The nurse explores the client's underlying concerns.
Understanding why the client is refusing (e.g., fear, misunderstanding) provides essential data for the healthcare team.
4
Advocate and communicate the change in status.
The healthcare provider and charge nurse are notified.
The provider must be informed that consent is withdrawn so they can either speak with the client to provide primary education or cancel the procedure.
5
Record the event in the medical record.
The client's exact words and the provider notification are documented.
Accurate documentation is a legal requirement that must occur after all immediate patient care and advocacy actions are completed.

Anahtar Kavram

Client Autonomy and the Right to Refuse Treatment
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