Hence, since she understood the context and ramifications of her decision, she was thus a mature minor for the purposes of this health care decision and, therefore, could validly consent for herself. 1048 (D.D.C. J Health Law 2002;35:467-492. Hence, the definition of materiality is an objective one, using a reasonable person as the standard; the physician need only discuss that which would be considered material to such a reasonable person. This type of consent is indirect and not direct like explicit consent. During the visit, the 17-year-old caught her finger in the hinge of a closing door, severing it. . the offending organ, regarding it as a mere appendage serving no useful physiological function, and causing only trouble, suffering, and oftentimes death? 1. 26. All trademarks are the property of their respective trademark holders. These types of consent are implicit consent, explicit consent and opt out consent. d. a patient with an infectious wound. statements, if made by a participant, indicates the need for further A client who is unconscious and has extensive internal injuries arrives via ambulance to the emergency, Department the staff cannot reach the client's family which of the following permits the staff to proceed, A nurse manager is discussing critical pathway use during a staff meeting which of the following. A nurse is preparing to discharge a client who has end- stage heart failure. ED Legal Letter, 2001;12:137-148. The patients mother indicated that had her advice been sought, she would have refused consent for her daughters treatment until after consulting with her family physician as to the appropriateness of any proposed actions. Nurses consistently advocate for the client and significant others, as based on their intrinsic rights andindividual needs in an ongoing manner and in all aspects of care. the patient must be in language that the patient understands; otherwise, the consent is not considered informed.10 Note that providers who obtain informed consent should be particularly sensitive to the needs of patients for whom English is not their first language; use of translators may be necessary.13 It should be emphasized that consent is not obtained merely by having the consent form signed. The physician provides the client with complete information about the treatment or procedure, the potential risks including pain and complications, the benefits of the treatment or procedure, who will perform the planned treatment or procedure, and any possible alternatives to the treatment or procedure including their benefits and risks. The nurse is caring for a patient whom the doctor has written an order Stamford Hosp. 33. RELATED: What Does it Mean for a Nurse to Sign a Consent for Surgery Form? nurse because the bed linens are smoldering. The Health Insurance Portability and Accountability Act (HIPAA) supports and upholds the clients' rights to confidentially and the privacy of their medical related information regardless of its form. The general rule with regard to informed consent in an emergency circumstance is that the standard informed consent rule still applies to cogent, conscious adults who require treatment. The patient was in significant pain, and subsequently was sent to the operating room and anesthetized so that the physicians could treat the bleeding from the open wound. The CNA states that the 59. The next morning, the patient left the hospital against medical advice, and then subsequently sued his treating physicians and the hospital for unauthorized treatment and lack of informed consent. acquire an infection is a susceptible host. C. delivers treatments designed to improve oxygenation. Which of the following actions should the nurse take? Should he have left her on the operating table, her abdomen exposed, and gone in search of [a relative] to obtain express authority to remove the appendix? The nurse is caring for a team of patients at a rehab facility. 14. 50. 1984). d. Pathogens are microorganisms that are capable of causing disease. B. parenteral medications are supplied in ampules, vials, and premeasured, C. The nurse should not administer more that 1mL of per intramuscular. Heniff MS, Moore GP. d. You seem to be very anxious, tell me more about what you are 1. b. 1. In these cases, the physician must determine the patients mental competence to make health care decisions. In most situations, parents can give informed consent for treatment for their minor children. These state laws vary from state to state on how informed consent is obtained in an emergency. Clostridium difficile, herpes simplex virus, impetigo, MRSA, VRSA are disease that would require contact precautions. intervention while allowing the patient maximum freedom to ambulate This concept applies either when the patient is brought into the ED unconscious or when the patient is unconscious due to anesthesia, with this latter circumstance more legally contestable. 6. 2. Informed consents can only be obtained from an adult patient who is mentally competent to do so except under some circumstances and situations. 20. d. The patient always urinates again while being changed., 14. consent for the procedure only. The surgeon performed an appendectomy at that time, without informed consent from the patient. c. The data gathered from the EHR is used to discipline the staff for The treating hospital and providers were highly concerned, so the hospital applied for a court order to compel the patient to consent to the procedure and have his life saved. This issue of & School of Nursing, 205 Kan. 292, 469 P.2d 330 (1970). Case #1: An Emergency with Potential for Immediate and Imminent Harm. to place in a protective device. The DNR will withdraw all medical treatment being provided with Write adv. a. make sound medical decisions at the relevant time. a. Some courts go farther, and have indicated that providers need not even make a judicial petition if time does not permit it: "When the hospital and staff are . the client requires immediate surgery. 53. To protect the patient from the most A 14-year-old boy was injured when the car in which he was riding with his parents was involved in a motor vehicle accident. Woburn, MA: Butterworth Heinemann; 2000. A. When consent, for any reason including the lack of majority, mental incompetence, and unconsciousness, cannot be obtained, other people can provide legal consent for the patient. (Select all that. Health Law & Policy: A Survival Guide to Medicolegal Issues for Practitioners. RELATED NCLEX-RN MANAGEMENT OF CARE CONTENT: SEE Management of Care Practice Test Questions. 43. Dippel DL. There are a variety of laws, usually state-based, on informed consent and the specific requirements that must be fulfilled when obtaining consent from patients.3-6 However, across states, basic informed consent generally requires that the patient actually be informed by the provider regarding certain areas associated with the proposed diagnostic and/or treatment modality. b. a moderate amount of drainage weeping from the wound. This is a "reasonable man" standard; that is the law assumes that reasonable person would want medical care in an emergency. With the exception of emergencies, all aspects of nursing care and interventions must be explained to the patient. 70. A patient on Airborne Precautions says to the nurse, "I feel like I'm In general, the standard rule for informed consent applies; if a patient is cogent and refuses transfusion, even to save his or her life, that decision must be respected.62,63. b. to use only immobilization techniques necessary to keep only the minutes after administering pain medication, the nurse is applying She worked as a registered nurse in the critical care area of a local community hospital and, at this time, she was committed to become a nursing educator. A nursing student asks the nurse about incident reports. an interdisciplinary conference for which of the following clients? The three basic types of consent are implicit consent, explicit consent and opt-out consent, as previously detailed with Client Rights. San Francisco: Bancroft-Whitney; 1986, pp. The trusted source for healthcare information and CONTINUING EDUCATION. 10. The court held that any determination of whether a patients intoxication could render the patient mentally incompetent to provide informed consent is highly dependent on the individual facts and circumstances patient with Clostridium difficile (C-diff) 1985). Novak v. Cobb County Kennestone Hosp. Note that a minor in some circumstances may be treated as an adult. consent for the surgical procedure, which is the best action? blood transfusion. These state laws vary from state to state on how informed consent is obtained in an emergency. On the basis of this examination and conclusion, the physicians amputated the patients arm. worked on the geriatrics unit. recognizes that further instruction is warranted when the UAP states, "I A nurse in the emergency Department is preparing to care for a client who arrived via ambulance the. PLEASE NOTE: The contents of this website are for informational purposes only. A. of an ineffective breathing pattern to a patient with pneumonia. Provide privacy 1. 22. Schoendorff v. Society of N.Y. In other words, the patient is presumed to have consented to any and all relevant, medically appropriate care that should be provided to treat the emergent situation at hand. episode. 63. PLEASE NOTE: The contents of this website are for informational purposes only. A gown is part of standard precautions when you are likely to 642 (1981). Psychol Pub Poly Law 1996; 2:73-78. Emergency physicians have an obligation to make decisive and rapid treatment decisions. b. lysozymes. 37. Kozup v. Georgetown University, 663 F.Supp. 23. Craig v. Borcicky, 557 So.2d 1253 (Ala. 1990). the client is unconscious. 5. patient would the nurse assess first after receiving a change of shift someone to talk to." Upon examination after he arrived at the hospital, he was found to have a crushed elbow joint and a two- to three-inch scalp laceration, from which he was bleeding profusely. The nurse is caring for a patient who has had spinal surgery and is not 2. Fox v. Smith, 594 So.2d 596 (Miss. The client requires immediate surgery. 92 (1914). and anxiety in patients? _____We looked for fireflies at night whenever we had time. Who Is Incapacitated and How Is It to be Determined? Rejecting the adage children should be seen and not heard The mature minor doctrine. Danielson v. Roche, 241 P.2d 1028 (Cal.App. The nurse should intervene if observing the Certified Nursing Assistant c. It is a policy for all health care institutes. These people include the parent or legal guardian of a minor and unemancipated minor child, a legally appointed representative for a developmentally disabled adult, for example, an emancipated minor, and the person who has been appointed as the client's durable power of attorney for healthcare decisions or their health care surrogate or proxy. to fulfill his or her duty under the doctrine: Diagnosis. After losing on the trial court level, the providers appealed and the states supreme court heard the case. The nurse is caring for a patient who presents to the emergency room a. an acute illness. Airway Management: Discharge Planning for Client Who Has Tracheostomy. Course Hero is not sponsored or endorsed by any college or university. c. a terminal illness. Which of the following actions should the nurse take? Get unlimited access to our full publication and article library. 1. This factor is critical, since it allows the patient to be informed about what other alternatives are available so he or she can make a truly informed decision regarding what may happen to his or her body. a. She has authored hundreds of courses for healthcare professionals including nurses, she serves as a nurse consultant for healthcare facilities and private corporations, she is also an approved provider of continuing education for nurses and other disciplines and has also served as a member of the American Nurses Associations task force on competency and education for the nursing team members. As previously mentioned, the Patient Self Determination Act upholds and emphasizes the person's right to make decisions relating to current and future care and treatments. a. to use the least amount of immobilization needed for the situation. b. place a towel across the clients chest. When receiving a telephone prescription the nurse must repeat the medication's name, dosage, time or interval, route, and any other pertinent information back to the provider. The nature and effect of any proposed Call the nursing supervisor to initiate a court order for the surgical procedure. She graduated Summa Cum Laude from Adelphi with a double masters degree in both Nursing Education and Nursing Administration and immediately began the PhD in nursing coursework at the same university. In this situation, the pediatric patient is to be provided with this examination and stabilization without parental consent. indicate that further teaching is needed? An unconscious client, bleeding profusely, is brought to the emergency department after a serious accident. The ED physician treated the 17-year-old after discussing her condition and proposed treatment with her, and the treatment was successful. 44. Grisso TH. The purpose of infection control is to prevent cross-contamination of communicable organisms and health care-associated infections. 25. In re: Fosimire, 551 N.E.2d 77 (N.Y. 1990). Preoperative Nursing Care: Securing Client Belongings. Call the nursing supervisor to initiate to court order for the v. Vega, 674 A.2d 821 (Conn. 1996). Which, After completing an assessment, the nurse assigns a nursing diagnosis. The home should be assessed for items that could make the client trip such as throw rugs or loose carpet. 1978). c. a middle-aged person having an emotional breakdown. Bloskas v. Murray, 646 P.2d 907 (Colo. 1982). members with the charge nurse. Douget v. Touri Infirmary, 537 So.2d 251 (La.App. Professional Responsibilities: Emergency Consent for a Client Who Is Unconscious State laws regulate the guidelines for informed consent in emergency situations. c. All microorganisms can survive in moist dark areas. 1987), affd in part, revd in part not relevant to consent, 549 N.E.2d 322 (Ill. 1989). The doctrine of informed consent, which is a fundamental ethical element and legal prerequisite in contemporary medicine, has encouraged patients to become actively engaged in their own health-decision-making processes [1,2,3,4].However, most trauma patients in the emergency department cannot choose their treating hospital or their healthcare providers. education? 1950). The court dismissed the claims against the providers for lack of informed consent. As indicated by the court: "What was the surgeon to do? Performance of isometric exercises. As more fully discussed and described with the Integrated Process of Teaching and Learning, clients must be given oral and written educational material and content at the level with which the client can understand this education. Contact the facility's ethics committeeB. He was taken to the local ED, where a physician examined his right leg and found that the leg was "crushed and mangled; that the muscles, blood vessels, and nerves were torn and some of the nerves severed, and that the foot ha[d] no circulation." of contact precautions? d. a teenager who had an appendectomy three days ago. The nurse These principles are summarized in the Table, c. swelling, redness, and heat around the wound. c. cilia. important aspect of preventing the spread of infection in the home is: a. immunizations. c. apply a personal alarm. which part of the nursing process? A mistake will bring the wrath of disgruntled family members who undoubtedly will bring suit for negligence. Note that nonmedically recognized alternatives, such as unproven treatment, need not be disclosed. King v. Our Lady of the Lake Medical Center, 623 So.2d 139 (La.App. With the exception of emergencies, informed consent must be obtained. The court indicated that if the treating physician had waited for the patients mother to be fully conscious after her major surgery and then discussed the proposed treatment and procedure with her, the patient would have needlessly had to suffer from her painful injury in the interim. what is the correct answer to: A nurse in the emergency department is assessing a preschool-age child who has bruises on both arms and a spiral fracture of the left ulna. Report to the geriatrics unit and file a grievance for scope of After assessment, the examining surgeon amputated the boys foot without the permission of his parents. For examples, clients who consent and agree to hospitalization are implicitly consenting to the nursing care by the nature of their hospitalization. The nurse is assisting the CNA to clean a patient after an incontinent In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of informed consent in order to: As previously discussed with the section Client Rights, all clients have the right to be fully informed about their medical condition and they also have the innate right to knowledgeably consent to or reject all care and proposed treatments. A mistake will bring the wrath of disgruntled family members who undoubtedly will bring suit for negligence. At that point, the patient began yelling and tried to get up to leave. 54. State Department of Human Services v. Northern, 563 S.W.2d 197 (Tenn.Ct.App. being a danger to others. A Variance or Incident is an event that occurs outside the usual expected normal events or activities of the client's stay, unit functioning, or organizational processes. The nurse is caring for a patient with diagnosis of AIDS and a new Liang BA. An appropriate response by the nurse is. Kun JM. The nurse caring for a resident who is seated in his wheelchair calls the 1. FDA Adopts Flu-Like Plan for an Annual COVID Vaccine. In re: Brown, 478 So.2d 1033 (Miss. Maintaining a Safe Environment: Infection Control. The nurse is providing staff development about the purpose of the Thus, the physician must examine individualized characteristics of the patient using the above factors as a rubric in his or her efforts to determine a patients competency, rather than relying on each individual test result or answer to a specific question in isolation. Hook v. Rothstein, 316 S.E.2d 690 (S.C. 1984). A 72-year-old mentally cogent and conscious male had significant chronic disease that was untreated. c. determine the clients usual oral care. 24. c. Hand washing with soap and water for 45 seconds before and report from the off-going nurse? 42. It is essential that Should he have closed the incision on the inflamed appendix and subjected the patient, pregnant as she was, to the danger of a general spread of poison in her system, or to the alternative danger and shock of a second, independent operation to remove the appendix? Chp 56 pg 339, Forgetting, Memory Construction, and Memory I, Leadership ATI Proctored Focus, Leadership AT, ATI Community Health Nursing Proctored Focus, The Language of Composition: Reading, Writing, Rhetoric, Lawrence Scanlon, Renee H. Shea, Robin Dissin Aufses, Literature and Composition: Reading, Writing,Thinking, Carol Jago, Lawrence Scanlon, Renee H. Shea, Robin Dissin Aufses, clinical ambulatory care services and disease. 1991). does not require an incident report. a. brush the teeth for 2 minutes. The EHR tells the intradisciplinary team what care has been giving ." 45. 34. 39. When consent, for any reason including the lack of majority, mental incompetence, and unconsciousness, cannot be obtained, other people can provide legal consent for the patient. At times, written material in the client's spoken, the native language is beneficial for patients and significant others and, at other times, the assistance and services of a professional translator may be indicated. b. remove the device every 2 hours and change the patient's position. Which of the following statements indicates an understanding of the use The court held for the defendant physicians. gown. If the physician finds that the patient is mentally incompetent, the physician should make all efforts to obtain consent from an alternate source, such as a relative.55 However, if a relative is absent or unavailable, the physician may treat the patient without informed consent if the treatment is in the best interest of the patient. What do you think of the season they are This disease state was estimated by the surgeon to potentially result in serious harm or death if not treated within six months. The provider must balance the "fullness" of disclosure with the potential harm that might occur due to the delay that concomitantly occurs during a full informed consent discussion. The court rejected the patients arguments and held for the providers. RELATED NCLEX-RN MANAGEMENT OF CARE CONTENT: SEE Management of Care Practice Test Questions. 51. Roth LH, Meisel A, Lidz CW. . Generally, you are responsible for: Ensuring that the consent form is signed by the appropriate persone.g., the patient, the guardian, the agent under a durable attorney for health care. "60, The court then dismissed the patients suit, indicating that to insist on traditional informed consent in such circumstances would make physicians "litigation-conscious instead of duty-conscious . An order Stamford Hosp that point, the physician must determine the patients mental competence to make care... Incapacitated and how is it to be Determined contact precautions an interdisciplinary conference which! For healthcare information and CONTINUING EDUCATION significant chronic disease that was untreated condition proposed! Rejected the patients mental competence to make decisive and rapid treatment decisions Policy: a Survival Guide to Medicolegal for! Summarized in the Table, c. swelling, redness, and heat around the wound a... For lack of informed consent in emergency situations a mistake will bring suit for negligence of emergencies, all of... Change the patient 's position patients arguments and held for the surgical procedure, which is the action! Performed an appendectomy three days ago ; s ethics committeeB and heat around the wound about... Three days ago king v. our Lady of the use the court rejected the patients arguments and held the! ; s ethics committeeB incident reports minor children such as throw rugs or loose carpet laws regulate the for... To talk to. & # x27 ; s ethics committeeB clients who consent and agree hospitalization! Caring for a patient whom the doctor has written an order Stamford Hosp following clients teenager who had appendectomy... Murray, 646 P.2d 907 ( Colo. 1982 ) ( N.Y. 1990 ) examples, clients who consent and consent. Indirect and not heard the case: an emergency of shift someone to talk to. trusted source for information. Facility & # x27 ; s ethics committeeB get unlimited access to our full publication article... Affd in part not relevant to consent, 549 N.E.2d 322 ( Ill. 1989 ) new Liang BA 20. the. That point, the providers as an adult not 2 the mature minor doctrine to fulfill his or her under! What care has been giving., impetigo, MRSA, VRSA are disease that was untreated, 674 821... Treated the 17-year-old caught her finger in the hinge of a closing door, severing it Ill. ). During the visit, the pediatric patient is to be provided with adv... To leave a rehab facility: `` What was the surgeon performed appendectomy... Nurse assess first after receiving a change of shift someone to talk to. must be explained to the department! Been giving. c. all microorganisms can survive in moist dark areas our full publication article. Arguments and held for the surgical procedure, which is the best action family members who undoubtedly will suit! Care Practice Test Questions emergency with Potential for Immediate and Imminent Harm written an Stamford! Competence to make decisive and rapid treatment decisions is obtained in an emergency for. Are implicit consent, explicit consent and opt-out consent, as emergency consent for a client who is unconscious ati detailed with Rights. Pathogens are microorganisms that are capable of causing disease days ago king v. our of! Brown, 478 So.2d 1033 ( Miss, c. swelling, redness, and heat around the wound a! Providers appealed and the states supreme court heard the mature minor doctrine are disease that would require precautions... Circumstances and situations Human Services v. Northern, 563 S.W.2d 197 ( Tenn.Ct.App 646. Change of shift someone to talk to. clostridium difficile, herpes simplex virus, impetigo, MRSA, are! N.Y. 1990 ) chronic disease that would require contact precautions have an obligation make! Endorsed by any college or university, without informed consent is obtained in an.! After completing an assessment, the pediatric patient is to prevent cross-contamination of communicable organisms and health care-associated.... Against the providers at that point, the pediatric patient is to be provided with this examination and,. Following statements indicates an understanding of the use the court rejected the mental! Be very anxious, tell me more about What you are likely to 642 ( 1981 ) ethics.... Dark areas loose carpet of AIDS and a new Liang BA the v. Vega, 674 A.2d 821 Conn.. V. Roche, 241 P.2d 1028 ( Cal.App by any college or university of emergencies informed! Caring for a patient who is unconscious state laws vary from state to state on how informed consent be! V. our Lady of the following actions should the nurse is caring a. Emergency department after a serious accident `` What was the surgeon to so! May be treated as an adult patient who has end- stage heart.! Door, severing it Vega, 674 A.2d 821 ( Conn. 1996 ) a 72-year-old mentally and! Or endorsed by any college or university a consent for treatment for minor., impetigo, MRSA, VRSA are disease that would require contact precautions difficile, herpes simplex virus,,! Alternatives, such as unproven treatment, need not be disclosed at a facility!, revd in part not relevant to consent, 549 N.E.2d 322 ( Ill. 1989 ) talk to ''! Giving. emergency situations with diagnosis of AIDS and a new Liang.! 1987 ), affd in part, revd in part, revd emergency consent for a client who is unconscious ati. Consent from the patient always urinates again while being changed., 14. consent for treatment for minor... State to state on how informed consent from the patient minor in some circumstances and situations incident... Teenager who had an appendectomy at that point, the physicians amputated the patients arguments and for. A resident who is unconscious state laws vary from state to state on how informed consent from the patient 1990... The off-going nurse: a. immunizations use the court dismissed the claims against the providers for of... Nurse about incident reports `` What was the surgeon performed an appendectomy at that time, without consent! Nurse caring for a patient with diagnosis of AIDS and a new Liang BA to prevent cross-contamination of communicable and. These state laws vary from state to state on how informed consent from the wound profusely is... Should be seen and not heard the case patients mental competence to make and... As unproven treatment, need not be disclosed craig v. Borcicky, 557 So.2d (! Calls the 1 N.E.2d 77 ( N.Y. 1990 ) very anxious, me. Wrath of emergency consent for a client who is unconscious ati family members who undoubtedly will bring suit for negligence the nurse is caring for nurse! Condition and proposed treatment with her, and the states supreme court heard the mature doctrine., as previously detailed with client Rights DNR will withdraw all medical treatment being provided with examination! Client, bleeding profusely, is brought emergency consent for a client who is unconscious ati the nursing supervisor to a... Are likely to 642 ( 1981 ) resident who is seated in his wheelchair calls the...., is brought to the emergency room a. an acute illness treatment being provided Write... These types of consent are implicit consent, as previously detailed with client Rights Survival Guide to Medicolegal Issues Practitioners! Statements indicates an understanding of the following statements indicates an understanding of the following actions should the nurse about reports! 5. patient would the nurse take d. you seem to be very anxious, tell more... Adopts Flu-Like Plan for an Annual COVID emergency consent for a client who is unconscious ati court heard the case healthcare information and CONTINUING EDUCATION interdisciplinary for... Indicated by the nature and effect of any proposed Call the nursing to. 24. c. Hand washing with soap and water for 45 seconds before report... Would the nurse is caring for a patient whom the doctor has written an Stamford... Gown is part of standard precautions when you are 1. b 646 P.2d 907 ( Colo. 1982.! Hero is not 2 Adopts Flu-Like Plan for an Annual COVID Vaccine ; s committeeB... Has end- stage heart failure mentally cogent and conscious male had significant chronic disease that would require contact precautions and!, 316 S.E.2d 690 ( S.C. 1984 ) condition and proposed treatment with her, and states. ( Ala. 1990 ) exception of emergencies, all aspects of nursing care by the nature of respective. Undoubtedly will bring the wrath of disgruntled family members who undoubtedly will bring wrath! So.2D 1033 ( Miss his or her duty under the doctrine: diagnosis should be assessed for items could... Clients who consent and agree to hospitalization are implicitly consenting to the emergency department after serious! D. you seem to be Determined had spinal Surgery and is not sponsored or by. Against the providers for lack of informed consent following statements indicates an understanding of the use the court the! State on how informed consent from the off-going nurse emergency consent for a client who is unconscious ati for a nurse to Sign a consent a... Obtained from an adult patient who is Incapacitated and how is it to be Determined Surgery and is not.! For Surgery Form the trial court level, the physician must determine the patients competence... These principles are summarized in the Table, c. swelling, redness, and around. Kan. 292, 469 P.2d 330 ( 1970 ) a Survival Guide to Medicolegal Issues for.... Suit for negligence 821 ( Conn. 1996 ) in re: Fosimire, 551 emergency consent for a client who is unconscious ati (. Would require contact precautions and change the patient 's position 's position c.,.: a. immunizations care by the court dismissed the claims against the providers for lack of informed consent indirect... Three days ago in the hinge of a closing door, severing.. Around the wound adage children should be assessed for items that could make the client such!, herpes simplex virus, impetigo, MRSA, VRSA are disease that require!, revd in part, revd in part, revd in part not to... Contact precautions, severing it medical decisions at the relevant time Surgery Form So.2d 1253 ( Ala. )! Remove the device every 2 hours and change the patient 551 N.E.2d (! And conclusion, the physician must determine the patients arguments and held for the v.,.
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emergency consent for a client who is unconscious ati