A nurse is caring for a group of clients on a medical-surgical unit. The nurse should ensure that the client has signed an informed consent form prior to which of the following procedures? (Select all that apply)

A) The surgeon should delay surgery until he can obtain informed consent from a parent:

This option is not feasible in emergencies where immediate surgical intervention is required to save the client's life or prevent further harm. Delaying surgery could jeopardize the client's health and violate the principle of beneficence, which prioritizes the client's well-being.

B) The client's pediatrician can obtain implied consent:

While pediatricians often play a role in providing medical care to minors, implied consent typically pertains to emergency situations where immediate intervention is necessary, and obtaining consent from a parent or legal guardian is not possible. In this scenario, the surgeon, rather than the pediatrician, would be responsible for obtaining consent.

C) The surgeon can proceed with the surgery by invoking implied consent:

In emergency situations where immediate surgical intervention is required to prevent harm or save a client's life, healthcare providers may proceed with treatment under the doctrine of implied consent. Implied consent assumes that a reasonable person would consent to necessary medical treatment if they were able to do so. However, the specific legal requirements for invoking implied consent may vary depending on jurisdiction and institutional policies.

D) The surgeon can obtain informed consent from the client's adult cousin:

While obtaining consent from a close family member may be necessary in certain situations, such as when a parent is unavailable, it may not be legally sufficient in emergency situations where immediate action is required. Additionally, the legal authority to provide consent may vary depending on the jurisdiction and the client's age. In this scenario, relying on informed consent from the client's adult cousin could delay necessary surgical intervention and may not be appropriate without further legal clarification.

A. "My attorney will need to notarize the document."

This statement indicates a misunderstanding of advance directives. Notarization by an attorney is not a requirement for advance directives. While legal advice may be helpful in completing advance directive documents, notarization by an attorney is not necessary for their validity.

B. "I have to choose a member of my family to be my health care surrogate."

This statement is incorrect. While a family member can serve as a health care surrogate if chosen by the individual, there is no requirement to select a family member. The individual can choose any competent adult to act as their health care surrogate, regardless of familial relationship.

C. "Once the form is notarized, it cannot be changed."

This statement is incorrect. Advance directive documents can be changed or revoked at any time by the individual as long as they are of sound mind and able to make decisions. Notarization does not prevent changes or revisions to the document.

D. "My health care surrogate can decide my treatment if I am unable to."

Correct. This statement demonstrates an understanding of advance directives. A health care surrogate, also known as a health care proxy or durable power of attorney for health care, is a person chosen by an individual to make medical decisions on their behalf if they become unable to do so. This includes decisions about medical treatment, procedures, and end-of-life care.