A charge nurse on a pediatric unit is reviewing informed consent guidelines with a newly licensed nurse. For which of the following clients should the nurse obtain informed consent from a guardian?
A 15-year-old client who requires an open reduction of a fracture.
A 6-month-old infant requiring IV antibiotics.
14-year-old client seeking prenatal care.
A 5-year-old child requiring a chest x-ray.
The Correct Answer is A
A. A 15-year-old client who requires an open reduction of a fracture. Minors generally require parental or guardian consent for surgical procedures unless emancipated.
B. While an infant cannot consent, IV antibiotics are considered a routine medical treatment. General consent for treatment is usually signed upon admission to the hospital, which covers standard nursing interventions like starting an IV or administering prescribed medications. Specific informed consent forms are typically reserved for higher-risk procedures (surgeries, blood transfusions, etc.).
C. In most jurisdictions, minors can provide their own consent for medically emancipated conditions. These typically include prenatal care, contraception, testing and treatment for STIs, and substance abuse treatment. The nurse would not need to obtain consent from a guardian in this specific context to protect the minor's privacy and access to care.
D. A chest x-ray is a non-invasive diagnostic procedure. Similar to the administration of medications, these are covered under the general consent for treatment signed at the time of admission. They do not require a separate, formal informed consent document for each individual imaging study.
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Related Questions
Correct Answer is C
Explanation
A. Passive range of motion exercises are contraindicated during acute joint swelling and bleeding, as they can exacerbate bleeding into the joints (hemarthrosis).
B. Aspirin is contraindicated as it can impair platelet function and worsen bleeding in clients with bleeding disorders.
C.Offering an electronic tablet helps to distract the toddler and prevent unnecessary movement, which could worsen joint bleeding or discomfort.
D. Warm packs are contraindicated during acute joint swelling; cold packs should be used to reduce bleeding and swelling.
Correct Answer is B
Explanation
A. "I will take my child's rectal temperature daily.": Taking a rectal temperature in a child receiving chemotherapy is not recommended because it increases the risk of rectal injury and infection. An oral or axillary temperature is preferred.
B. "I will make sure to inspect my child's mouth every day for sores." Chemotherapy suppresses the immune system, leaving the child vulnerable to infections such as mucositis. Inspecting the mouth daily is crucial to detect any sores or signs of infection early and prevent complications.
C. "I will make sure my child gets their MMR vaccine this week.": Live vaccines like the MMR (measles, mumps, rubella) vaccine should not be given during chemotherapy or other forms of immunosuppressive treatment.
D. "I will ensure my child exercises a little each day by riding their bicycle.": Exercise may be limited during chemotherapy due to fatigue and increased susceptibility to infection. Physical activity should be tailored to the child's ability and energy level, not mandated.
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