Author Question: The family of an 88-year-old man with an acute exacerbation of chronic obstructive lung disease is ... (Read 101 times)

Diane · **on:** Jul 7, 2018

The family of an 88-year-old man with an acute exacerbation of chronic obstructive lung disease is at his bedside. He is experiencing dyspnea and placement on a ventilator is suggested.

The patient is DNR and does not want extreme measures taken, but is unable to speak for himself. One daughter supports placement on a ventilator while the other believes that it will only add to his suffering. Which of the following statements by a nurse might facilitate communication between these family members? 1. Can you tell me if he has ever been on a ventilator before, and how he responded to it then?
2. Given this confusion, maybe we should discuss his DNR status; I can go get the information we have on file.
3. I know that this is a difficult situationperhaps you would like to talk with a clergy person to help in making the decision.
4. I'm sure that it is difficult seeing your father like this, can we spend a few minutes talking about your concerns at this time?

Question 2

Which of the following is essential to provide the means to search the literature and apply clinical knowledge, improving practice and safety as well as meeting the standards of excellence required for regulatory and credentialing standards and

Magnet status? 1. Information technology tools
2. Computerized databases
3. Technology websites
4. Online libraries

b614102004 · **Reply #1 on:** Jul 7, 2018

Answer to Question 1

4

Feedback
1 Asking this question might prompt conversation, but it focuses more on patient response than on the daughters' opposing opinions.
2 A therapeutic conversation is intended to address concerns in the attempt to alleviate suffering; resorting to the DNR status request is something that best comes later in the conversation when the father's wishes are addressed.
3 Nurses are capable of dealing with family interaction and conflict because of their family-focused communication skills; a response like this might send the message that the nurse does not want to deal with the issue.
4 An open ended statement such as tell me your concerns about this illness and hospitalization can allow the family to share their illness story.

Answer to Question 2

1
Rationale: Information technology (IT) tools are essential to provide the means to search the literature and apply clinical knowledge, improving practice and safety as well as meeting the standards of excellence required for regulatory and credentialing standards and Magnet status.