A nurse is caring for a client on the medical-surgical unit. The client has been taking warfarin at home and her INR is 3.5. The client states she is checking herself out of the hospital and refuses to wait until her provider can discuss the situation with her. Which of the following actions should the nurse take?

Choice A reason: Notifying the provider is important but not the first action. The client’s decision to leave AMA requires immediate documentation via an AMA form to protect legally and ensure clarity, making this secondary. Choice B reason: Asking the client to sign an AMA form documents their informed decision to leave against medical advice with an INR of 3.5, reducing legal risks and ensuring the client acknowledges the dangers, making this the correct action. Choice C reason: Explaining risks is valuable but does not address the legal requirement of documenting AMA discharge. The AMA form ensures the client’s decision is recorded, making this choice secondary to form signing. Choice D reason: Requesting security is inappropriate, as competent clients can refuse care. Forcing the client to stay violates autonomy, and the AMA form is the correct step, making this choice incorrect.