A nurse is caring for a client who has an IV in the left forearm and whose infusion pump has alarmed several times. Which of the following actions should the nurse take first?

Choice A rationale: According to the American Nurses Association (ANA) Code of Ethics, the nurse should respect the client's right to self-determination and autonomy. The nurse should also provide the client with adequate information and ensure that the client understands the risks and benefits of the procedure. If the client is unable to read or write, the nurse should witness the client's mark on the consent form and document it in the medical record.
Choice B rationale: Contacting the client's power of attorney may be necessary in certain situations, but involving a family member directly for consent is generally more immediate and practical.
Choice C rationale: Notifying the surgical team about the client's inability to sign the consent is important, but the more immediate action is to involve a family member in the consent process.
Choice D rationale: This violates the client’s right to autonomy, unless the client requests or authorizes it.

Choice A rationale: Having a prescription for long-term IV antibiotic therapy is expected for treating osteomyelitis and does not necessarily require a referral.
Choice B rationale: A HbA1c of 6% for a client with type 2 diabetes mellitus is within the target range, and the nurse can address diabetes management without an immediate referral.
Choice C rationale: A prescription for furosemide, a diuretic, is not directly related to the management of osteomyelitis and does not require a referral.
Choice D rationale: A WBC count of 20,000/mm3 suggests an elevated white blood cell count, which may indicate an ongoing infection. This finding requires further evaluation and possible intervention, making a referral necessary.