A nurse is caring for a client who is recovering from a stroke. The provider recommends an extracranial-intracranial bypass, but the client tells the nurse that he will not have the surgery. Which of the following actions should the nurse take?

Choice A rationale:

The age of the client might influence the care plan and potential complications, but it's not the primary factor for evaluating cost effectiveness. Cost efficiency is more directly related to the resources utilized during the client's stay.

Choice B rationale:

The availability of community support groups contributes to the client's psychosocial well-being and support network, but it doesn't directly assist in evaluating the cost effectiveness of care. This factor focuses more on the quality of life after discharge.

Choice C rationale:

This is the correct choice. The length of the client's stay directly impacts the cost of care. A longer stay involves more resources, medications, and services, leading to increased costs. Evaluating and optimizing the length of stay is a critical aspect of cost-effective care.

Choice D rationale:

The type of insurance the client carries affects their financial responsibility for the care received, but it's not the main consideration for evaluating cost effectiveness. It primarily influences the patient's out-of-pocket expenses rather than the overall cost of care.

The correct answer is choice B: "This is a procedure that does not require written informed consent."

Choice B rationale: Informed consent is typically required for invasive procedures, surgery, or treatments that carry significant risks. While inserting an indwelling urinary catheter is considered an invasive procedure, it is generally not a procedure that requires written informed consent. Nurses often have standing orders or standardized procedures in place for catheterization, and consent is usually implied or obtained verbally.

Choice A rationale: Although providers prescribe procedures, consent is still necessary in many cases. However, as mentioned above, written informed consent is not typically required for urinary catheter insertion due to its routine nature in medical care.

Choice C rationale: Discussing the issue with the charge nurse is unnecessary since written informed consent is not generally required for this procedure. The nurse should instead focus on educating the family about standard hospital practices.

Choice D rationale: Asking the family to sign the informed consent form at this point is not appropriate, as it implies that the procedure should not have been performed without written consent. Additionally, urinary catheterization does not typically require written informed consent, so asking them to sign a form could create confusion or unnecessary concern.