The newly graduated nurse is caring for an elderly client on the medical-surgical floor. The nurse recalls learning about client advocacy. Which actions by the nurse indicate an understanding of client advocacy?

Select all that apply.
  1. The nurse speaks to the daughters regarding care-making decisions, since the client is elderly and may not understand.
  2. The nurse tells the family that they should really consider making the client an organ donor in case something happens.
  3. The nurse makes sure the client understands treatment options, including possible outcomes if the client refuses treatment.
  4. The nurse obtains an interpreter for the client if her native language is not English and she only understands her native language.
  5. The nurse asks the client for a copy of advance directives or a living will, or provides information if the client does not have one.
Numbers 3, 4, and 5 are correct.
Rationale: Responses 3, 4, and 5 are examples of how a nurse keeps the client’s interest at the focus of care and maintains the role of client advocate. One of the duties is making sure that the client understands treatment options, including possible outcomes if the client refuses treatment. The nurse must also ensure that the client receives instruction in her native tongue if she does not speak English. This is especially important when obtaining consent for surgery and other invasive procedures. Copies of living wills, advance directives, and other legal health care documents should be placed in the client’s chart if available. Only speaking to family members regarding the client’s care is rude and does not show consideration for the client’s wishes for her care. The nurse should not insist that any client become an organ donor. The nurse’s opinion is secondary to the client’s wishes. The nurse serves as a client advocate by following the client’s wishes, not pushing what he thinks is best for the client.