Question

A nurse is caring for a 4-year-old child with end-stage leukemia. The child's physician has ordered a lumbar puncture. His mother, who has legal custody, has refused to give consent for the child to undergo the procedure. However, the child's father is demanding that the procedure be performed. What should the nurse do first?

1. Prepare the child for the lumbar puncture because the father wants the procedure to be performed.
2. Inform the father that the procedure won't be performed because the mother didn't consent.
3. Ask the child if he would like to have the procedure.
4. Contact social services and the child's physician.

Answer 1

The nurse should contact social services and the child's physician when dealing with parental consent conflicts for a medical procedure like a lumbar puncture. The procedure is performed in the lower lumbar region to avoid spinal cord damage and test for conditions such as meningitis.

Step-by-step explanation:

In a situation where a medical procedure such as a lumbar puncture is ordered for a child, and one parent consents while the other does not, the nurse should first contact social services and the child's physician. Legal custody differences can complicate medical decisions, and it is essential to follow the hospital's policies and legal guidelines. In this case, as the mother has legal custody and refuses consent, her decision must be respected above the father's demand.

The lumbar puncture procedure is performed in the lower lumbar area of the vertebral column because the spinal cord ends above this region, making it safer to insert a needle without risking damage to the spinal cord. This procedure is vital for testing for conditions like meningitis, as seen in the clinical examples provided.