A client with end-stage renal disease knows that he is dying but ...

[james9437]

A client with end-stage renal disease knows that he is dying but refuses to talk about it with his spouse. At times the spouse talks with the nursing staff about the client's condition but adamantly refuses to discuss death with the client.
 
  What will be the outcomes of this situation?
 
  1. Client has dignity
  2. Client has privacy
  3. Client can finalize affairs
  4. Client can plan own funeral
  5. Client burdened with no one to confide in

Question 2

During the bath, the client suddenly says, I am not going to get well. I think I am going to die. What response given by the nurse is most appropriate?
 
  1. Let's think of something more cheerful.
  2. You are doing so well; don't talk like that.
  3. What makes you think you are dying?
  4. Whatever is meant to be will happen.

[gasdhashg]

Answer to Question 1

Correct Answer: 1, 2, 5

Rationale: With mutual pretense, the client, family, and health care personnel know that the prognosis is terminal but do not talk about it and make an effort not to raise the subject. Mutual pretense permits the client a degree of dignity.

Answer to Question 2

Correct Answer: 3
Rationale 1: Let's think of something more cheerful is changing the subject.
Rationale 2: You are doing so well, don't talk like that is offering false reassurance and devaluing the client's concern.
Rationale 3: The nurse should ask what it is that makes the client think about dying. This allows the nurse to collect and evaluate data before making a further response.
Rationale 4: Whatever is meant to be will happen is being fatalistic and devaluing the client's concerns.

[james9437]

Excellent

[scottmt]

Thanks for the timely response, appreciate it