Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?

Choice A rationale:

The nurse should not carry on with surgical preparation without signed informed consent. This action would be ethically and legally inappropriate. Informed consent is essential for any surgical procedure to ensure the client understands the risks and benefits. Without it, the surgery cannot proceed. Additionally, proceeding without informed consent can lead to legal issues and violation of the client's rights.

Choice B rationale:

Asking the unresponsive client's friend to sign the informed consent is not the appropriate action. Informed consent should ideally be obtained from the client themselves or a legally designated representative, such as a guardian or family member. While it may be difficult to obtain informed consent from an unresponsive client, the nurse should explore other options, such as locating a legal guardian or following institutional policies for obtaining consent in emergency situations.

Choice C rationale:

Notifying the unit manager that an emergency court order is needed is not the first action the nurse should take. While obtaining a court order may be necessary in some situations, it is a time-consuming process and not the most immediate course of action in an emergency. The priority in this situation is to ensure the client receives life-saving surgery as soon as possible while adhering to ethical and legal principles.

Choice D rationale:

Continuing to provide life support until a thorough search for a guardian is completed is the most appropriate action in this situation. The nurse should prioritize the client's well-being and life-saving measures. While it is important to obtain informed consent, it should not delay necessary surgical intervention. Providing life support maintains the client's stability and buys time to locate a guardian or family member who can provide informed consent. It is in line with the principle of beneficence, ensuring the client's best interests are served.

Choice A rationale:

Encouraging the client to face their fear gradually is an appropriate nursing intervention for a client with a phobia. This approach is consistent with exposure therapy, which is a widely recognized and effective treatment for phobias. Exposure therapy involves gradually exposing the client to the feared object or situation in a controlled and supportive environment. By doing so, the client can learn to confront and manage their fear over time. This approach is evidence-based and helps the client build resilience and reduce anxiety.

Choice B rationale:

Administering benzodiazepines as needed for acute anxiety (Choice B) is not the first-line treatment for phobias. While benzodiazepines can provide temporary relief from anxiety symptoms, they do not address the underlying phobia and can lead to dependence and tolerance with prolonged use. Moreover, they are generally reserved for acute anxiety episodes and not considered a primary treatment for phobias.

Choice C rationale:

Providing psychoeducation about the causes and effects of phobias (Choice C) is a valuable component of treatment, but it alone may not be sufficient. Psychoeducation can help clients understand the nature of their phobia and reduce stigma, but it should be combined with evidence-based therapies like exposure therapy for comprehensive care.

Choice D rationale:

Teaching the client relaxation techniques to manage anxiety (Choice D) can be a helpful adjunct to treatment, but it is not the primary intervention for phobias. Relaxation techniques can be part of a broader strategy to reduce anxiety, but the client also needs exposure therapy or cognitive-behavioral therapy to address the phobia directly.