Question

The nurse on the 3-11 shift is assessing the chart of a client with an abdominal aneurysm scheduled for surgery in the morning and finds that the consent form has been signed, but the client is unclear about the surgery and possible complications. Which is the most appropriate action? A. Call the surgeon and ask him or her to see the client to clarify the information B. Explain the procedure and complications to the client C. Check in the physician's progress notes to see if understanding has been documented D. Check with the client's family to see if they understand the procedure fully

Short answer

Answer: The most appropriate action for the nurse to take is to call the surgeon and ask him or her to see the client to clarify the information about the procedure and its complications. This ensures that the client receives accurate and sufficient information from the expert and allows them to make an informed decision about the surgery.

Step-by-step solution

Read and Understand the Question

To solve this exercise, it is necessary to read the entire scenario and understand what is required. The nurse has discovered that the client is unclear about the surgery and its complications. It is crucial to determine the most appropriate action for the nurse.

Evaluate Choice A

Choice A suggests that the nurse should call the surgeon and ask him or her to see the client to clarify the information. This is a possible option, as the surgeon is the most knowledgeable about the procedure. However, this might not be the best course of action depending on the other choices.

Evaluate Choice B

Choice B states that the nurse should explain the procedure and complications to the client. While it might be a good idea for the nurse to provide some support and general information, the nurse might lack the knowledge or experience to adequately explain the particular surgery and its potential complications. The surgeon or the physician should address these questions.

Evaluate Choice C

Choice C suggests that the nurse should check the physician's progress notes to see if the client's understanding has been documented. This could provide some insight into whether the client has already been informed about the procedure and complications. However, this would not address the issue of the client still feeling unclear about the surgery.

Evaluate Choice D

Choice D proposes to check with the client's family to see if they understand the procedure fully. Although the family's understanding is important, this option does not address the client's need for information about the surgery and its risks. The client has the right to be informed themselves to make a well-informed decision.

Choose the Most Appropriate Action

After evaluating all the choices, the most appropriate action is Choice A: Call the surgeon and ask him or her to see the client to clarify the information. This action ensures that the client receives accurate and sufficient information directly from the expert, allowing the client to make an informed decision about the surgery and potential complications.

Key concepts

Clinical Judgment in Nursing

Clinical judgment in nursing refers to the application of critical thinking skills and evidence-based practice to make decisions regarding patient care. It is a complex cognitive process that involves assessment, analysis, and synthesis of patient information.

In the context of the exercise, the nurse must exercise clinical judgment to determine the best way to ensure the patient is fully informed about their upcoming surgery. This includes identifying that there is a gap in the patient's understanding and evaluating the best course of action to address it. Clinical judgment drives the nurse to consider calling the surgeon, who has the most precise knowledge of the surgical procedure and possible complications, to explain this to the patient.

This process exemplifies how nurses must interpret and integrate various sources of information, prioritize actions, and coordinate care to advocate for their patient's best interests and safety.

Patient Consent for Surgery

Obtaining informed consent is a fundamental ethical and legal requirement before any surgical procedure. It involves more than just getting a signature on a document; patients must understand the nature of the surgery, the expected benefits, potential complications, and alternative options.

In the exercise we reviewed, a signed consent form is present, yet the patient lacks clarity regarding the surgery. This situation signals a breakdown in the consent process, as informed consent is only valid if the patient comprehensively understands it. The nurse recognizes this issue and seeks to correct it by proposing to call the surgeon to provide a thorough explanation to the patient.

This underlines the importance of ensuring true informed consent is completed as part of ethical patient care and not just treated as a bureaucratic step in the surgical process.

Communication with Surgical Patients

Effective communication with surgical patients is pivotal, as it plays a role in patient satisfaction, adherence to postoperative instructions, and overall outcomes. Communication should be clear, empathetic, and tailored to the patient's level of understanding.

In the given exercise, the patient's lack of understanding points to a need for improved communication. The recommended action of having the surgeon provide further clarification demonstrates the importance of direct communication from the healthcare provider performing the procedure. It emphasizes the nurse's role in facilitating this communication to ensure that the patient's concerns are addressed and that they are prepared for the surgery both mentally and physically.

Nursing Ethics

Nursing ethics encompasses the moral principles that guide the practice of nursing. Key aspects include patient autonomy, beneficence, nonmaleficence, and justice.

Within the scenario presented, the nurse must navigate an ethical landscape to ensure the patient's right to informed consent is honored. The decision to involve the surgeon directly adheres to these ethical principles, with the recognition that the patient has autonomy over their own healthcare decisions and should be fully informed before surgery. The nurse's role includes acting as an advocate for the patient's rights and ensuring that all actions are taken with the patient's best interests at heart.