The male client had a hemicolectomy. The client is refusing to wear the prescribed sequential compression devices (SCDs). What is most important for the nurse to communicate to the client? A)An appropriate form must be signed, verifying refusal B)Complications, including death, could result C)The client will be billed for the equipment regardless D)The surgeon will be informed of the refusal

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Just as there is informed consent, there is informed refusal. The client should be made aware of all the possible complications (including the possible worst-case scenario, which is usually death) when making a decision, and this should be documented. The nurse should try to work with the client to get at least partial compliance when it is in the client's best interest (eg, wear the SCDs for a limited time). (Option A) This would occur, but it is more important to make the client aware of the potential implications of this refusal so that the client can make an informed refusal. (Option C) Safe, quality care is the priority, not financial concerns. The nurse should avoid discussing financial implications when a client is making care decisions. (Option D) Depending on the hospital policy, a refusal to wear the SCDs could result in an additional form being completed and the refusal documented in the medical record. Documentation should include the information given to the client and the client's understanding of that information. Even if the client refuses to sign the form, the nurse should obtain other witnesses and document the refusal in detail in the medical record. Educational objective: The most important aspect of a client's refusal for treatment is to make sure that the client is informed of the potential results of the refusal.

The Male Client Had a Hemicolectomy