A nurse is observing a newly licensed nurse perform a sterile dressing change on a client who has a central venous catheter. Which of the following actions should the newly licensed nurse take?

The correct answer is choice B: "This is a procedure that does not require written informed consent."

Choice B rationale: Informed consent is typically required for invasive procedures, surgery, or treatments that carry significant risks. While inserting an indwelling urinary catheter is considered an invasive procedure, it is generally not a procedure that requires written informed consent. Nurses often have standing orders or standardized procedures in place for catheterization, and consent is usually implied or obtained verbally.

Choice A rationale: Although providers prescribe procedures, consent is still necessary in many cases. However, as mentioned above, written informed consent is not typically required for urinary catheter insertion due to its routine nature in medical care.

Choice C rationale: Discussing the issue with the charge nurse is unnecessary since written informed consent is not generally required for this procedure. The nurse should instead focus on educating the family about standard hospital practices.

Choice D rationale: Asking the family to sign the informed consent form at this point is not appropriate, as it implies that the procedure should not have been performed without written consent. Additionally, urinary catheterization does not typically require written informed consent, so asking them to sign a form could create confusion or unnecessary concern.

The correct answer is b. Inform the assistive personnel of the client’s weight-bearing status.

Choice A: Assess the client’s incision every 8 hours for the first 48 hours. While it is important to monitor the incision site for signs of infection, the frequency of every 8 hours for the first 48 hours may not be necessary unless specified by the surgeon or the patient’s condition warrants it.

Choice B: Inform the assistive personnel of the client’s weight-bearing status. This is the correct answer. After a total hip arthroplasty, it’s crucial to communicate the client’s weight-bearing status to all members of the healthcare team, including assistive personnel. This helps ensure that everyone is aware of the client’s mobility limitations and can assist the client safely.

Choice C: Instruct the client to cross their legs at the ankles when sitting in a chair. This is not recommended. After a hip arthroplasty, patients are typically advised not to cross their legs to prevent dislocation of the new hip joint.

Choice D: Teach the client’s partner to assist the client to flex the hip at least 120° each hour. This is not recommended. After a hip arthroplasty, patients are typically advised to avoid flexing the hip more than 90 degrees to prevent dislocation of the new hip joint1. Therefore, flexing the hip at least 120° each hour could potentially harm the patient.