Author Question: The nurse is caring for a terminally ill older patient who has a living will that excludes pulmonary ... (Read 116 times)

washai · **on:** Jul 11, 2018

The nurse is caring for a terminally ill older patient who has a living will that excludes pulmonary and cardiac resuscitation. The family expresses a concern that the patient may change her mind. The nurse best reassures the family by stating

a. The nursing staff will watch her very closely for any indication she has changed her mind.
b. We will discuss her wishes with her reg-ularly.
c. She can change her mind about any pro-vision in the document at any time.
d. Your mother was very clear about her wishes when she signed the document.

Question 2

The nurse is caring for an unresponsive patient who has terminal cancer with a Do Not Resuscitate order in effect

A family member tells the nurse, I'll sue you and every other nurse here if you don't do everything possible to keep her alive. The nurse understands that protection from legal prosecution in this situation is provided by:
a. legal immunity granted when acting ac-cording to the patient's expressed wishes.
b. the legal view that the duty to put into effect the patient's wishes falls to the physician.
c. knowledge of and compliance with facili-ty policies and procedures regarding end-of-life care.
d. implementing interventions that preserve the patient's right to self-determination.

fromAlphatoOmega22 · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

A
AMD provisions appropriately provide that people can change their minds at any time and by any means. Nurses need to be alert to any indications from a patient. Based on the person's medical condition, subtle signs such as a gesture or a nod of the head may be easily overlooked. The patient may or may not be able to discuss her condition. Stating that the mother was very clear in her wishes does not take into account the fact that patients can change their minds any time.

Answer to Question 2

C
In this case, immunity applies only to the physician and not to the nurse because the physician is given the legal duty to put into effect the patient's wishes. Consequently, the nurse must rely on effective communication with the physician, patient, and family, and on the quality of the facili-ty's policies and procedures, to be sure that his or her actions are consistent with the legally re-quired steps.