A three-year-old child has a brain tumor and is now dying. The ...

[kshipps]

A three-year-old child has a brain tumor and is now dying. The child has an Allow Natural Death order (AND order). Which of the following care and interventions are allowed for a child with an AND order? Standard Text: Select all that apply.
 
  1. Oxygen
  2. Suctioning
  3. Use of a ventilator if respiratory failure occurs
  4. Pain control
  5. Cardiac compressions

Question 2

Which of these strategies would be most effective for a teachable moment for the parents of a four-year-old child during a routine office visit?
 
  1. Discuss with the parents preparation for school because the child will start kindergarten next year
  2. Review five-year-old anticipatory guidelines with the parents.
  3. Select one topic that is a common problem or concern for parents of four-year-olds and present a brief amount of information on the topic.
  4. Review all four-year-old anticipatory guidelines with the parents.

[jordangronback]

Answer to Question 1

1,2,4
Rationale 1: The child with an AND order may still receive oxygen to provide comfort.
Rationale 2: Suctioning of secretions would be appropriate for a child with an AND order.
Rationale 3: In most cases when a patient has an AND and respiratory arrest occurs, there will be no attempts to initiate resuscitation activities.
Rationale 4: The goal of AND orders is to maintain comfort of the patient while not continuing futile efforts to restore life. Pain control would be appropriate.
Rationale 5: Should the heart fail, external attempts to restart the heart would be inappropriate.
Global Rationale:

Answer to Question 2

3
Rationale 1: Unless the parents raise the issue, preparation for school should be discussed closer to the event.
Rationale 2: Giving too much information to the parents at one time can result in them forgetting important information due to overload; selecting one topic and presenting information is appropriate.
Rationale 3: Children and families often learn best when presented with small bits of information.
Rationale 4: Giving too much information to the parents at one time can result in them forgetting important information due to overload; selecting one topic and presenting information is appropriate.
Global Rationale:

[kshipps]

TYSM

[ebonylittles]

Excellent