A nurse in an emergency department is caring for a client who is unconscious and requires surgery. There is no one available to give consent for the treatment. Which of the following actions should the nurse take?
Prepare the client for surgery.
Contact the facility's ethics committee for guidance.
Keep the client stable until a family member arrives to give consent.
Obtain consent from the surgeon.
None
None
The Correct Answer is A
A. In emergency situations where the client is unconscious and requires immediate life-saving surgery, implied consent is assumed. The nurse should prepare the client for surgery without waiting for family members or a formal consent process. Delaying treatment could jeopardize the client's life.
B. Contacting the ethics committee could delay the urgent care needed in an emergency situation. Immediate action should be taken in the best interest of the client.
C. Waiting for a family member to arrive could delay critical care, which may lead to worsening of the client's condition or even death.
D. The surgeon does not need to provide consent. It is the healthcare team's responsibility to act in the client's best interest when the client is unable to provide consent in an emergency.
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Related Questions
Correct Answer is A
Explanation
- Rationale for A: Rolling the client as one unit helps maintain spinal alignment and prevents further injury. It ensures that no additional strain is placed on the injured area, which could exacerbate pain or cause further damage. This method distributes the client's weight evenly and avoids twisting movements that could be harmful.
- Rationale for B: While flexing the client's knees may be part of the process to prepare for repositioning, it is not the most critical action to take. Flexing the knees alone does not ensure the safety of the client's lower back and could potentially lead to discomfort or injury if not done in conjunction with other measures.
- Rationale for C: Placing the client's arms at their sides is not advisable as it does not provide any support or stability during the repositioning process. Arms should be positioned in a way that they do not bear weight or interfere with the movement, ensuring the client's comfort and safety.
- Rationale for D: While placing the client on the side of the bed nearest the direction they will be turned may seem practical, it is not the primary action to ensure the client's safety. This position does not address the need for maintaining proper spinal alignment or the smooth, controlled movement required to protect the lower back injury.
Correct Answer is B
Explanation
A. Advising to discuss with the provider doesn't address the immediate concern of potential harm.
B. Asking about thoughts of self-harm assesses the client's immediate safety.
C. Inquiring about medication discontinuation is important but not as urgent as addressing suicidal ideation.
D. While understanding the relationship is important, it's not the priority when a client expresses suicidal thoughts.
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