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Soru

Zorluk: OrtaInformed Consent

A registered nurse is caring for a client with early-stage Alzheimer's disease on a telemetry unit. The client is scheduled for an elective permanent pacemaker insertion. The healthcare provider has completed the explanation of the procedure's risks, benefits, and alternatives. When the nurse approaches to witness the consent, the client states, 'I understand that I need this pacemaker to fix my abnormally slow heart rate.' The client's adult child intervenes, stating, 'My parent is naturally confused from old age and should not sign anything; I will sign the form.' Which of the following actions should the nurse take? Select all that apply.

  1. Assess the client privately to confirm they are signing the document voluntarily and without family coercion.Cevap
  2. Witness the client's signature on the informed consent form.Cevap
  3. Document in the medical record that the client verbalized an accurate understanding of the procedure's purpose.Cevap
  4. D
    Agree with the adult child that confusion is a normal physiological part of the aging process and allow the child to act as the surrogate decision-maker.
  5. E
    Reassure the client by stating, 'Do not worry, your doctor is excellent and this is a completely safe procedure,' before obtaining the signature.
  6. F
    Delegate the task of witnessing the client's signature on the consent form to the unlicensed assistive personnel (UAP) while attending to another client.

Cevap

The nurse should assess the client privately to rule out family coercion, witness the client's signature on the consent form, and document the client's verbalized understanding in the medical record.
The registered nurse's primary roles during the informed consent process are to witness the client's signature, ensure the client is acting voluntarily without coercion, and verify that the client comprehends the procedure. Because the client is alert and accurately articulates the need for the pacemaker, they demonstrate the capacity to consent at this time. A diagnosis of early-stage Alzheimer's does not automatically render a client legally incompetent. Therefore, the nurse should witness the signature, document the client's verbalized understanding, and assess for any undue influence from the family member.

Adım Adım Çözüm

1
Evaluate the client's current capacity to consent.
The client demonstrates a clear understanding of the pacemaker insertion and its purpose.
A diagnosis of early-stage Alzheimer's disease does not automatically negate legal competence; capacity must be evaluated at the time the decision is being made.
2
Address the adult child's interference and assumption about aging.
The nurse recognizes that confusion is not a normal part of aging and ensures the client is not being pressured.
The nurse acts as a client advocate to confirm that the consent is given voluntarily and without undue influence from surrogate decision-makers when the client retains capacity.
3
Complete the legal and documentation requirements for informed consent.
The nurse witnesses the signature and thoroughly documents the interaction.
The registered nurse's explicit role in the consent process is to witness the signature, confirm voluntariness, and verify the client's understanding of what the provider explained.

Anahtar Kavram

Informed Consent and Client Advocacy
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Konular

Informed Consent

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