A nurse is preparing to discharge a client who had a cerebrovascular accident and has left-sided weakness. The client is having difficulty completing ADLs. Which of the following is the priority action by the nurse?

A) Send the client for the test with the unsigned form:

This option is not appropriate because performing an invasive procedure without obtaining informed consent from the client violates ethical and legal principles. Proceeding without proper consent could lead to legal and ethical repercussions, and it is not considered a safe or acceptable practice.

B) Wake the client and ask them to sign the form:

Waking the client who has received a sedative to obtain their signature on the consent form is not advisable. The client may still be under the influence of the sedative, which could impair their ability to understand the information provided and make an informed decision. Additionally, obtaining consent in this manner may not be legally valid and could compromise the client's autonomy and rights.

C) Obtain consent from a family member:

While obtaining consent from a family member might seem like a reasonable option, it is not appropriate in this scenario without clear documentation of the client's inability to provide consent. Consent for medical procedures should ideally be obtained directly from the competent adult client unless they are incapacitated or unable to make decisions. In this case, the client is asleep due to the sedative, but there is no indication that they are incapable of providing consent. Therefore, relying on a family member's consent without attempting to obtain it from the client first may not be ethically or legally justified.

D) Inform the charge nurse:

This is the most appropriate action to take initially. Informing the charge nurse allows for consultation and guidance on how to proceed in this situation. The charge nurse may advise on the appropriate steps to follow, such as contacting the provider or waiting for the client to regain consciousness to obtain informed consent. It ensures that the situation is addressed promptly and in accordance with institutional policies and ethical standards.

A) "I respect your right to choose to discontinue treatment."

While this statement acknowledges the client's autonomy and right to make decisions about their care, it does not directly address the nurse's commitment to honesty or transparency in discussing hospice care.

B) "I will have a hospice nurse come discuss this kind of care with you."

While involving a hospice nurse is a supportive action, it does not directly demonstrate the nurse's commitment to honesty or openness in discussing hospice care with the client.

C) "I will answer any questions you have about hospice care honestly."

This statement demonstrates veracity by explicitly stating the nurse's commitment to providing truthful and accurate information about hospice care. It reassures the client that they can trust the nurse to provide honest answers to their questions.

D) "I work with hospice services to help you transition to their care."

While this statement indicates the nurse's involvement in facilitating the transition to hospice care, it does not specifically address the nurse's commitment to honesty or truthfulness in discussing hospice care with the client.