What is the primary nursing intervention for a patient exhibiting signs of acute respiratory distress and suspected impaired gas exchange?

A. Administer diuretics: Diuretics should not be the first action for oliguria in a post-surgical patient until the underlying cause is identified. If the low output is due to hypovolemia, diuretics would further deplete the intravascular volume and worsen renal perfusion. They require a specific provider order based on diagnostic data.

B. Check the patency of the urinary catheter: Low urine output in the PACU may be due to mechanical obstruction rather than renal failure or hypovolemia. The nurse must first ensure that the drainage system is not kinked or blocked to get an accurate reading. This simple, non-invasive assessment must precede pharmacological or surgical interventions.

C. Notify the primary surgeon: While the surgeon should be informed of significant changes, the nurse must first perform a basic assessment to provide a complete report. Checking the catheter allows the nurse to determine if the issue is a simple mechanical problem. Notification is the next step if patency is confirmed.

D. Increase the rate of IV fluids: Bolusing fluids is a common treatment for prerenal oliguria, but it should not be done before checking for mechanical obstruction. If the patient has a blocked catheter, increasing fluids will only cause bladder distension and discomfort. Fluid titration must be guided by accurate output measurements.

A. The LPN decides the timing of the informed consent discussion:The surgeon or proceduralist is legally responsible for initiating and timing the discussion regarding surgical risks and benefits. An LPN does not have the independent authority to determine when this legal requirement occurs. The timing is dictated by the surgical schedule and physician availability.

B. The LPN witnesses the client's signature on the consent form:This role confirms that the correct patient voluntarily signed the document while appearing to be of sound mind. The witness does not certify that the patient understands all clinical risks but validates the identity and signature. This is a standard administrative task within the LPN scope.

C. The LPN provides detailed information about the surgical procedure:Explaining the technical complexities, potential complications, and alternative treatments is the exclusive duty of the performing physician. Providing such clinical details exceeds the LPN scope of practice and could lead to legal liability. The LPN only reinforces information already provided by the surgeon.

D. The LPN can sign the consent form on behalf of the patient:Informed consent requires the patient or a legal healthcare proxy to provide authorization for invasive interventions. A nurse cannot legally sign as the patient unless they hold specific legal power of attorney. This action would violate ethical standards and legal mandates regarding patient autonomy.