A nurse is reviewing the plan of care for a group of clients.
The nurse should identify that informed consent is required for which of the following procedures?

Placement of a central venous catheter.

Insertion of a nasogastric tube.

Irrigation of a wound with antibiotic solution.

Administration of an iron injection using Z-track technique.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Informed consent is required for invasive procedures that carry significant risks or potential complications. Placement of a central venous catheter is an invasive procedure that involves inserting a catheter into a large vein, often in the neck, chest, or groin. It carries potential risks such as infection, bleeding, and injury to nearby structures. Therefore, informed consent is necessary before performing this procedure.

Choice B rationale:

Insertion of a nasogastric tube is an invasive procedure, but it is generally considered a routine and less risky procedure compared to others. Informed consent is typically not required for nasogastric tube insertion unless there are specific institutional policies or the client lacks decision-making capacity.

Choice C rationale:

Irrigation of a wound with antibiotic solution is a standard nursing procedure, and informed consent is not typically required for wound care unless there are specific circumstances that make it necessary, such as unusual risks or patient-specific considerations.

Choice D rationale:

Administration of an iron injection using Z-track technique is also an invasive procedure, but it is a common and well-established technique for administering intramuscular injections. Informed consent is not routinely required for this procedure unless there are specific institutional policies or the client's condition warrants it.

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Correct Answer is B

Explanation

The correct answer is Choice B.

Choice A rationale: This client has a new diagnosis and requires initial teaching about meal planning, which is typically a responsibility of a registered nurse (RN) due to the need for specialized knowledge and teaching skills.

Choice B rationale: This client has a low urinary output, which needs to be monitored, but the care required is within the scope of practice of a licensed practical nurse (LPN). They can manage and report findings to the RN.

Choice C rationale: This client has a low respiratory rate postoperatively, which could indicate respiratory depression. This requires immediate assessment and intervention from an RN, who can make complex clinical judgments and initiate appropriate care.

Choice D rationale: This client needs an admission assessment, which includes comprehensive initial evaluation. An RN is required for this as it involves detailed assessment, care planning, and initiation of care.

A. Massage the affected extremity every 4 hr. B. Administer aspirin for pain. C. Initiate bed rest. D. Apply an ice pack to the affected extremity for 20 min every 2 hr.

Correct Answer is C

Explanation

Choice A rationale:

Massaging the affected extremity is contraindicated in a client with deep-vein thrombosis (DVT) Massaging the area can dislodge the blood clot, leading to embolism and potentially life-threatening complications.

Choice B rationale:

Administering aspirin for pain is not the appropriate action for a client with deep-vein thrombosis. Aspirin is not the primary treatment for DVT, and it does not address the underlying cause or prevent further clot formation.

Choice C rationale:

Initiating bed rest is the correct action for a client with deep-vein thrombosis. Bed rest helps to reduce the risk of clot dislodgement and embolism. The client should avoid unnecessary movement and keep the affected leg elevated to promote blood flow and prevent complications.

Choice D rationale:

Applying an ice pack to the affected extremity is not the recommended intervention for a client with deep-vein thrombosis. Cold application can cause vasoconstriction, potentially worsening the condition by reducing blood flow to the already affected area.

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A nurse is reviewing the plan of care for a group of clients.
The nurse should identify that informed consent is required for which of the following procedures?