An unresponsive victim of a diving accident is brought to the emergency department where it is determined that immediate surgery is required to save the client's life. The client is accompanied by a close friend, but no family members are available. Which action should the nurse take first?
Ask the client's friend to sign the informed consent since the client is unresponsive.
Notify the unit manager that an emergency court order is needed to allow surgery.
Carry on with surgical preparation of the client without a signed informed consent.
Continue to provide life support until a thorough search for a guardian is completed.
The Correct Answer is C
Rationale
A. The client's friend may not legally be authorized to provide consent unless they hold medical power of attorney or legal guardianship for the client. Without documentation of such authority, the friend cannot sign the informed consent.
B. In emergency situations where a patient lacks decision-making capacity and there is no available legal guardian or next of kin to provide consent, hospitals may seek a court order to proceed with necessary treatment. However, this could delay emergency treatment.
C. This is based on the legal and ethical understanding that saving the patient's life takes precedence when immediate action is required and consent cannot be obtained.
D. Providing life support ensures that the client's immediate medical needs are addressed while efforts are made to locate a legal guardian. However, unavailability of next of kin should not delay definitive intervention
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E","F","G"]
Explanation
Correct choices;
Gravida 5, para 5 (G5P5)
This means the client has been pregnant 5 times and has given birth 5 times. Multiparity (having had multiple pregnancies and deliveries) is a risk factor for PPH due to uterine overdistension, which can lead to poor uterine tone and difficulty in contracting effectively after delivery.
Delivery of a 9 lb 1 oz (4.1 kg) baby
Larger babies are associated with an increased risk of PPH. The weight of the baby suggests a potentially larger placental surface area and increased uterine distension during pregnancy, which can contribute to uterine atony post-delivery.
Labor for 25 hours
Prolonged labor can lead to uterine exhaustion, where the uterus may not contract effectively after delivery, predisposing the client to PPH.
Forceps-assisted delivery
Instrumental deliveries, including forceps, can cause trauma to the birth canal, including the cervix, vagina, and perineum, increasing the risk of lacerations and bleeding.
Epidural anesthesia
Epidurals can mask the pain associated with uterine atony, which may delay the diagnosis of PPH. It's important to closely monitor uterine tone and blood loss in clients who have had epidurals.
4th degree laceration
Explanation: A 4th degree laceration involves the perineum and extends through the anal sphincter complex. Such extensive trauma increases the risk of significant bleeding postpartum.
Estimated blood loss of 600 mL
Although this is within the normal range of blood loss immediately after delivery, it still signifies that the client has experienced significant hemorrhage, putting her at higher risk for ongoing bleeding.
Correct Answer is ["1.3"]
Explanation
Convert pounds to kilograms.
- 1 pound = 0.453592 kilograms
- 132 pounds * 0.453592 kg/pound = 59.87 kilograms
Step 2: Calculate the total dose in micrograms.
- 44 micrograms/kilogram * 59.87 kilograms = 2635.08 micrograms
Step 3: Convert micrograms to milligrams.
- 1 milligram = 1000 micrograms
- 2635.08 micrograms / 1000 micrograms/milligram = 2.63508 milligrams
Step 4: Calculate the volume to be administered.
- Concentration of lorazepam = 2 milligrams/milliliter
- Volume = Dose / Concentration
- Volume = 2.63508 milligrams / 2 milligrams/milliliter = 1.31754 milliliters
Therefore, the nurse should administer approximately 1.3milliliters of the lorazepam solution.
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