Author Question: A competent elderly client has a living will. The living will expresses the desire to avoid ... (Read 36 times)

Evvie72 · **on:** Jul 22, 2018

A competent elderly client has a living will. The living will expresses the desire to avoid resuscitation and heroic life support measures. The family members are not supportive of this directive.

Which of the following actions by the nursing staff is most appropriate? 1. Contact the Social Services department
2. Notify the hospital attorney
3. Place the document on the chart
4. Explain to the client that the conflict could invalidate the document

Question 2

The nurse is caring for a client with degenerative joint disease who expresses the desire to remain active as long as possible. The nurse prepares to:

1. Teach the client nutrition and joint exercises.
2. Refer the client to the appropriate professionals.
3. Tell the client there is no hope.
4. Ask the client the reason for the decision.

bbburns21 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

3. Place the document on the chart

Rationale:
The client is competent. The wishes of the client must take priority. The document should first be placed on the chart and the physician notified. If there are concerns about the authenticity of the document, the Social Services department or the unit supervisor will need to be contacted. There is no need to notify the hospital attorney at this time. A lack of support by the family does not invalidate the document legally.

Answer to Question 2

2. Refer the client to the appropriate professionals.

Rationale:
The number of clients with chronic diseases with health care needs is increasing rapidly, and nurses and physicians cannot meet all of these clients' needs. When a client expresses the desire to live as normally as possible, the nurse should refer the client to professionals who can help the client meet those goals. The nurse can teach some nutrition and exercise but cannot go into the depth that this client would need. The client with a chronic disease should not be told there is no hope but should be helped toward reaching desired goals. Asking the client the reason for the decision is irrelevant to the situation.