A charge nurse making rounds observes that an assistive personnel has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?

a. A visitor experiences a minor burn after spilling coffee:

This situation does not present an ethical dilemma. It is a minor accident that can be addressed through appropriate first aid and safety measures.

b. A parent wants her 14-year-old adolescent to receive radiation treatment against his will:

This situation involves a conflict between parental authority and the autonomy of the adolescent. It raises questions about the adolescent's capacity to make medical decisions, the role of parental consent, and the rights of the adolescent to refuse treatment. Therefore, it represents an ethical dilemma.

c. A nurse witnesses another nurse administer an incorrect medication:

While this situation involves patient safety and professional responsibility, it does not inherently pose an ethical dilemma. It is a matter of patient safety and adherence to professional standards rather than conflicting moral principles.

d. A client receives an operation on the wrong side of her body:

This situation represents a serious medical error and a violation of patient safety protocols. While it may have ethical implications related to accountability, negligence, and patient harm, it primarily involves issues of medical error rather than a true ethical dilemma.

a. Transport the client to the operating room without verifying informed consent:

This option suggests an urgent response, prioritizing the immediate need for surgery over the formal process of obtaining informed consent. In certain emergency situations, such as when a patient's life or health is in imminent danger and obtaining consent is not feasible, healthcare providers may proceed with treatment or surgery to prevent further harm or loss of life. However, this approach should be guided by established protocols, legal considerations, and the principle of providing the best possible care for the patient.

b. Delay the surgery until the nurse can obtain informed consent:

This option advocates for ensuring that the patient's autonomy and rights are respected by obtaining informed consent before proceeding with surgery. While obtaining consent is essential, delaying surgery may not always be feasible or advisable in emergency situations where prompt intervention is necessary to prevent deterioration of the patient's condition. However, if circumstances allow, making efforts to obtain informed consent is ethically and legally preferable.

c. Obtain telephone consent from the facility administrator before the surgery:

This option proposes seeking consent from a designated authority within the healthcare facility, such as a facility administrator, via telephone. While this approach may be practical in some cases, it may not always be sufficient to ensure that the patient's rights are fully respected, particularly if the administrator does not have the legal authority to provide consent on behalf of the patient. In emergency situations, obtaining consent from a legally authorized representative of the patient, if available, is generally preferred.

d. Ask the anesthesiologist to sign the consent:

This option involves delegating the responsibility of signing the consent form to another member of the healthcare team, in this case, the anesthesiologist. However, consent for surgery should ideally be obtained directly from the patient or their legally authorized representative, as they are the ones who have the right to make decisions about their medical care. Relying on another healthcare provider to sign the consent form may not adequately protect the patient's autonomy and legal rights.