A nurse is caring for a client who is scheduled for a colostomy. The client tells the nurse to cancel the procedure. Which of the following responses should the nurse make?

A. "My attorney will need to notarize the document."

This statement indicates a misunderstanding of advance directives. Notarization by an attorney is not a requirement for advance directives. While legal advice may be helpful in completing advance directive documents, notarization by an attorney is not necessary for their validity.

B. "I have to choose a member of my family to be my health care surrogate."

This statement is incorrect. While a family member can serve as a health care surrogate if chosen by the individual, there is no requirement to select a family member. The individual can choose any competent adult to act as their health care surrogate, regardless of familial relationship.

C. "Once the form is notarized, it cannot be changed."

This statement is incorrect. Advance directive documents can be changed or revoked at any time by the individual as long as they are of sound mind and able to make decisions. Notarization does not prevent changes or revisions to the document.

D. "My health care surrogate can decide my treatment if I am unable to."

Correct. This statement demonstrates an understanding of advance directives. A health care surrogate, also known as a health care proxy or durable power of attorney for health care, is a person chosen by an individual to make medical decisions on their behalf if they become unable to do so. This includes decisions about medical treatment, procedures, and end-of-life care.

A) Establishing the priorities of client care:

Establishing priorities of client care typically occurs during the planning phase of the nursing process, not during implementation. During the planning phase, the nurse identifies the most urgent client needs based on assessments and formulates a plan of action to address those needs.

B) Reinforcing teaching about the client's diagnosis:

Reinforcing teaching about the client's diagnosis is an appropriate activity during the implementation phase of the nursing process. Implementation involves carrying out the planned interventions, which may include educating the client about their diagnosis, treatment plan, and self-care strategies. Reinforcing teaching ensures that the client understands their condition and how to manage it effectively.

C) Asking the client about the presence of pain:

Assessing the client for pain is typically part of the assessment phase of the nursing process, not the implementation phase. During assessment, the nurse gathers data about the client's pain experience, including location, intensity, quality, and factors that alleviate or exacerbate pain.

D) Comparing the client's current laboratory values to previous results:

Comparing laboratory values is a component of data interpretation and analysis, which occurs primarily during the evaluation phase of the nursing process. While the nurse may review laboratory values during implementation to monitor the client's response to interventions, comparing current values to previous results is more closely associated with evaluating the effectiveness of care provided.