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) Assist in checking a unit of packed RBCS to administer to a client:

Assisting in checking a unit of packed red blood cells (RBCs) for transfusion is within the nurse's scope of practice. Nurses are responsible for verifying blood products before administration, ensuring compatibility, proper labeling, and appropriate handling to prevent transfusion reactions.

B) Regulate the client's infusion pump after initiating a heparin drip infusion:

Regulating the client's infusion pump after initiating a heparin drip infusion falls within the nurse's scope of practice. Nurses commonly administer and monitor intravenous medications, including heparin drips, and are responsible for regulating the infusion pump to deliver the medication at the prescribed rate.

C) Teach a client about hemodialysis:

Teaching a client about hemodialysis is within the nurse's scope of practice. Patient education is a fundamental aspect of nursing care, and nurses often provide information to clients and their families about various healthcare procedures, treatments, and self-care management, including hemodialysis.

D) Create a plan of care for a client's discharge:

Creating a plan of care for a client's discharge is within the nurse's scope of practice. Nurses are involved in discharge planning, which includes coordinating with the healthcare team, assessing the client's needs, providing education about post-discharge care, arranging follow-up appointments, and ensuring a smooth transition to the next level of care or home.