A nurse is caring for a 16-year-old client who was in a motor-vehicle crash and needs surgical intervention immediately. The staff cannot reach either of the client's parents. The nurse should identify that which of the following is true about obtaining consent?
The surgeon should delay surgery until he can obtain informed consent from a parent.
The client's pediatrician can obtain implied consent.
The surgeon can proceed with the surgery by invoking implied consent.
The surgeon can obtain informed consent from the client's adult cousin.
The Correct Answer is C
A. Delaying surgery in a life-threatening situation could endanger the client, so waiting for parental consent is not required under emergency circumstances.
B. The pediatrician does not have the authority to provide implied consent; this legal principle applies directly to the care team in emergency situations.
C. In emergency situations where a minor requires immediate, life-saving treatment and a parent or legal guardian is not available, implied consent allows the surgeon to proceed with necessary interventions to prevent harm.
D. An adult cousin does not have legal authority to provide consent for a minor’s treatment unless specifically designated as a legal guardian.
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Correct Answer is A
Explanation
A. Initiating oxygen therapy for a client with COPD is a priority because oxygenation is critical for clients with respiratory conditions. Hypoxia can lead to serious complications, making this intervention urgent.
B. While initiating a 24-hour urine collection is important for monitoring kidney function, it does not require immediate action compared to the need for oxygen therapy in a client with respiratory distress.
C. Administering antibiotics is essential, especially for a client with an infection like MRSA; however, the need for immediate oxygen therapy takes precedence over medication administration.
D. Changing the dressing for a decubitus ulcer is important for preventing infection and promoting healing but is not as time-sensitive as ensuring adequate oxygenation for the client with COPD.
Correct Answer is D
Explanation
A. Contacting the provider for instructions could delay immediate resuscitative efforts, which are required in the absence of a DNR order.
B. Consulting with the client’s family may not be effective in an emergency, as the living will is a legal document, and family members cannot override it without a DNR order.
C. Complying with the living will and letting the client expire naturally would be inappropriate without a formal DNR order in place.
D. Calling a code is the correct action because, legally, resuscitative efforts must be initiated in the absence of a written DNR order from the provider, despite the existence of a living will.