A nurse is caring for a client who has end-stage liver disease and is undergoing a paracentesis. Which of the following actions should the nurse take to evaluate the effectiveness of the procedure?

Choice A reason:

Offer to take pictures of the newborn for the client is the right choice, During the initial grieving process after experiencing a stillbirth, the nurse should offer to take pictures of the newborn for the client if the client wishes. Offering to take pictures is an essential and sensitive way to honour and validate the client's experience and the significance of their baby. It allows the client to have tangible memories of their child, which can be important for the grieving process and help in the healing journey.

It is crucial for the nurse to be supportive and compassionate during this time, respecting the client's emotional needs and preferences. Providing emotional support and empathy are critical components of caring for a client who has experienced the loss of a baby.

Choice B reason:

Assure the client that she can have additional children is not correct. While this statement may be well-intentioned, it may not be appropriate during the initial grieving process. The client may not be emotionally ready to discuss future pregnancies, and such assurances might minimize the significance of the loss they are experiencing. It is essential to be sensitive and refrain from making assumptions about the client's feelings or future plans.

Choice C reason:

Avoid talking to the client about the newborn. Avoiding talking to the client about the newborn may be seen as disregarding their feelings and emotions. Instead, it is essential to provide opportunities for the client to talk about their feelings and the baby if they wish to do so. Creating an environment where the client feels comfortable expressing their emotions can be crucial in the grieving process.

Choice D reason

Discouraging the client from allowing friends to see the newborn It is not appropriate for the nurse to discourage or prevent the client from allowing friends to see the newborn if they wish to do so. Grieving is a highly individual process, and some clients may find comfort and support in sharing their grief with loved ones. The nurse should respect the client's decisions regarding who they want to involve in their grieving process.

The correct answer is choice D. The nurse should determine if the client’s health care surrogate is aware of the risks and benefits of the procedure. A health care surrogate is a person who is authorized to make health care decisions for a client who is unable to do so. The nurse has a legal and ethical responsibility to ensure that the client’s surrogate has given informed consent for the surgery, which means that they have received adequate information about the procedure, its purpose, its risks, its benefits, and its alternatives.

Choice A is wrong because sending the unsigned informed consent form to the facility’s risk manager does not ensure that the client’s surrogate has given informed consent. The risk manager is not involved in the consent process and cannot authorize the surgery without the surrogate’s consent.

Choice B is wrong because ensuring that the client’s family supports the provider’s decision for surgery is not the same as obtaining informed consent from the surrogate.

The family may have different opinions or preferences than the surrogate, and the surrogate may not agree with the provider’s decision. The nurse should respect the surrogate’s autonomy and authority to make decisions for the client.

Choice C is wrong because determining if the procedure is medically necessary for the client is not the nurse’s role.

The provider is responsible for determining the medical necessity of the surgery and explaining it to the surrogate. The nurse should not question or interfere with the provider’s judgment unless there is evidence of negligence or malpractice.