A nurse is caring for a client who wants to stop receiving treatment for terminal cancer. The client's family asks the nurse if it is possible to continue the treatment without the client's knowledge. Which of the following responses should the nurse make?

A. The client cannot change their mind after signing consent. Clients have the right to withdraw consent at any time before the procedure begins.
B. The alternative treatments to the procedure should be explained. Informed consent includes information about alternative treatments and their risks/benefits so the client can make an informed decision.
C. The time of the procedure should be indicated on the form. The time of the procedure is not a required component of informed consent. The consent form should include the procedure details, risks, benefits, and alternatives
D. The charge nurse should review the form once it's signed. While nurses witness informed consent, they do not validate or review it. The provider performing the procedure is responsible for obtaining consent.

The first client the nurse should assess is Client 3 (Pulmonary Edema) followed by Client 1 (Hip Fracture).

Rationale:

Client 3 (Pulmonary Edema) – Highest Priority:

1. 1. Pulmonary edema is a life-threatening condition that can impair oxygenation.
   2. The client has a history of congestive heart failure (CHF) and a chest x-ray confirming pulmonary edema.
   3. Immediate assessment is required to evaluate for respiratory distress, oxygenation status, and potential need for diuretics or oxygen therapy.

Client 1 (Hip Fracture) – Second Priority:

1. 1. The x-ray confirms a fractured femoral neck, which can cause severe pain, bleeding, and immobility.
   2. The nurse must assess for circulation, sensation, and movement (CSM) of the affected limb and manage pain.
   3. While this is urgent, it is not as immediately life-threatening as pulmonary edema.

Priority Order (Using ABCs & Maslow’s Hierarchy):

1. Client 3 – Pulmonary Edema (Airway/Breathing concern)
   2. Client 1 – Hip Fracture (Risk for bleeding, pain, mobility issues)
   3. Client 4 – Low Potassium (Risk for cardiac arrhythmias, needs electrolyte management)
   4. Client 6 – Poor Diabetes Control (HbA1c 9%, requires education & glucose monitoring)
   5. Client 5 – Malnutrition (Prealbumin 12 mg/dL, needs nutrition support for wound healing)
   6. Client 2 – Hyperlipidemia (Not an immediate concern, requires long-term management)