A 3-year-old child is visiting the pediatric clinic. The nurse ...

[Capo]

A 3-year-old child is visiting the pediatric clinic. The nurse suspects that the child has a urinary tract infection (UTI). Which of the following methods is appropriate for the nurse to implement to obtain a urine specimen from the child?
 
  a. Use an indwelling catheter.
  b. Offer fluids 30 minutes in advance.
  c. Apply pressure over the urinary bladder.
  d. Place a diaper on the child and squeeze out the specimen.

Question 2

A patient has just been told that he has approximately six months to live and asks about advance directives. Which statements by the nurse give the patient correct information? (Select all that apply.)
 
  a. You have the right to refuse treatment at any time.
  b. If you want certain procedures or actions taken or not taken, and you might not be able to tell anyone at the time, you need to complete documents ahead of time that give your health care provider this information.
  c. You will be resuscitated at any time to allow you the longest length of survival.
  d. You might want to think about choosing someone who will make medical decisions for you in the event that you are unable to make your desires known.
  e. We will get someone who knows the state's guidelines to assist you in setting up your living will.
  f. If you travel to another state, your living will should cover your wishes.

[Chelseyj.hasty]

Answer to Question 1

B
Offering a young child fluids 30 minutes before requesting a specimen may help.
Because bladder catheterization carries the risk of UTI, blockage, and trauma to the urethra, it is preferable to rely on other measures for specimen collection.
Applying pressure over the urinary bladder of a child with an intact nervous system will not help and may create more stress in the child.
Squeezing urine from a child's diaper is not an accurate method of obtaining a urine specimen to determine whether the child has a UTI.

Answer to Question 2

A, B, D, E
The ethical doctrine of autonomy ensures the patient the right to refuse medical treatment. Living wills are written documents that direct treatment in accordance with a patient's wishes in the event of a terminal illness or condition. With this legal document, the patient is able to declare which medical procedures he or she wants or does not want when terminally ill or in a persistent vegetative state. Each state providing for living wills has its own requirements for executing the health care proxy or durable power of attorney for health care (DPAHC). This is a legal document that designates a person or persons of one's choosing to make health care decisions when the patient is no longer able to make decisions on his or her own behalf. This agent makes health care treatment decisions based on the patient's wishes. Cardiopulmonary resuscitation (CPR) is an emergency treatment provided without patient consent. Health care providers perform CPR on an appropriate patient unless a do not resuscitate (DNR) order has been placed in the patient's chart. The statutes assume that all patients will be resuscitated unless a written DNR order is found in the chart. Legally competent adult patients can consent to a DNR order verbally or in writing after receiving appropriate information from the health care provider. Differences among the states have been noted regarding advance directives, so the patient should check state laws to see if a state will honor an advance directive that was originated in another state.