As the nurse admits a patient in end-stage kidney disease to the ...

[Alainaaa8]

As the nurse admits a patient in end-stage kidney disease to the hospital, the patient tells the nurse, If my heart or breathing stop, I do not want to be resuscitated. Which action is best for the nurse to take?
 
  a. Ask if these wishes have been discussed with the health care provider.
  b. Place a Do Not Resuscitate (DNR) notation in the patient's care plan.
  c. Inform the patient that a notarized advance directive must be included in the record or resuscitation must be performed.
  d. Advise the patient to designate a person to make health care decisions when the patient is not able to make them independently.

Question 2

A young adult patient with metastatic cancer, who is very close to death, appears restless. The patient keeps repeating, I am not ready to die. Which action is best for the nurse to take?
 
  a. Remind the patient that no one feels ready for death.
  b. Sit at the bedside and ask if there is anything the patient needs.
  c. Insist that family members remain at the bedside with the patient.
  d. Tell the patient that everything possible is being done to delay death.

[pikon]

Answer to Question 1

ANS: A
A health care provider's order should be written describing the actions that the nurses should take if the patient requires CPR, but the primary right to decide belongs to the patient or family. The nurse should document the patient's request but does not have the authority to place the DNR order in the care plan. A notarized advance directive is not needed to establish the patient's wishes. The patient may need a durable power of attorney for health care (or the equivalent), but this does not address the patient's current concern with possible resuscitation.

Answer to Question 2

ANS: B
Staying at the bedside and listening allows the patient to discuss any unresolved issues or physical discomforts that should be addressed. Stating that no one feels ready for death fails to address the individual patient's concerns. Telling the patient that everything is being done does not address the patient's fears about dying, especially since the patient is likely to die soon. Family members may not feel comfortable staying at the bedside of a dying patient, and the nurse should not insist that they remain there.