A charge nurse on a pediatric unit is reviewing informed consent guidelines with a newly licensed nurse. For which of the following clients should the nurse obtain informed consent from a guardian?
A 15-year-old client who requires an open reduction of a fracture.
A 6-month-old infant requiring IV antibiotics.
14-year-old client seeking prenatal care.
A 5-year-old child requiring a chest x-ray.
The Correct Answer is A
A. A 15-year-old client who requires an open reduction of a fracture. Minors generally require parental or guardian consent for surgical procedures unless emancipated.
B. A 6-month-old infant requiring IV antibiotics. Informed consent from the guardian is required for medical interventions like IV antibiotics in infants.
C. A 14-year-old client seeking prenatal care. Pregnant minors in many jurisdictions are allowed to consent for their own prenatal care without a guardian's approval.
D. A 5-year-old child requiring a chest x-ray. While routine x-rays require parental consent, in an emergency, consent may not be necessary if immediate care is required to stabilize the child.
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Correct Answer is D
Explanation
A. Cover the equipment used in the infant's care prior to the parents' first visit: While this might reduce visual distress, it does not directly support the grieving process or involve the parents in meaningful interactions.
B. Reduce the parents' distress by limiting the duration of their visit: Limiting visit time may increase distress by reducing opportunities for the parents to process emotions.
C. Avoid leaving the parents alone with the infant during their visit: Parents may value privacy to express their feelings and bond with the infant without outside observation.
D. Involve the parents in the infant's caregiving activities during their visit. Involving parents in caregiving helps them feel connected to their child and provides meaningful time to bond, which supports healthy grieving.
Correct Answer is A
Explanation
A. Face, legs, activity, cry, consolability (FLACC) scale: The FLACC scale is appropriate for children aged 2 months to 7 years and assesses pain based on non-verbal cues such as facial expression, leg movement, activity, crying, and consolability.
B. Oucher scale and C. FACES scale are more appropriate for children aged 3 years and older who can self-report their pain.
D. Visual analog scale (VAS) is suitable for older children (typically 8 years and older) who can understand the concept of a continuum of pain.
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