A client is to receive a continuous Heparin infusion at s00 units per hour. Pharmacy supplies Heparin in a concentration of 25,000 units per 250mL of NSS.

Calculate the rate at which the nurse should set the infusion pump.

Choice A Reason: I am so relieved that my family can be with me when I die

This statement reflects an accurate understanding of hospice care. Hospice care often allows patients to be surrounded by their loved ones during their final days. It emphasizes comfort and support, ensuring that the patient is not alone.

Choice B Reason: I will have pain medicine available when I need it

This statement is also correct. One of the primary goals of hospice care is to manage pain and other symptoms to ensure the patient’s comfort. Pain management is a critical component of hospice care, and medications are readily available to address the patient’s needs.

Choice C Reason: In a few months, I will be strong enough to travel to my cabin and go fishing

This statement indicates a need for further education. Hospice care is typically provided to patients who have a life expectancy of six months or less and who are no longer seeking curative treatment. The focus is on comfort and quality of life rather than recovery or improvement in physical strength. The expectation of becoming strong enough to travel and engage in activities like fishing is unrealistic in the context of hospice care.

Choice D Reason: I will be able to be in my own bed and home until I die

This statement is accurate. Hospice care often allows patients to remain in their own homes, surrounded by familiar surroundings and loved ones. The goal is to provide a comfortable and supportive environment for the patient during their final days.

d. Interview the client alone and assess for abuse

Explanation of Choices

Choice A Reason: Provide the Daughter and Client with Nutritional Counseling

While nutritional counseling is important, especially given the client’s malnourished state, it is not the immediate priority in this scenario. The client’s reluctance to speak and the daughter’s interruptions suggest that there may be underlying issues that need to be addressed first. Nutritional counseling can be provided later, once the immediate concerns have been resolved.

Choice B Reason: Request a Psychiatric Evaluation for the Client

Requesting a psychiatric evaluation may be necessary if there are signs of mental health issues, but it is not the first step in this situation. The priority is to ensure the client’s safety and well-being by addressing any immediate concerns, such as potential abuse. A psychiatric evaluation can be considered after the initial assessment and intervention.

Choice C Reason: Take the History from the Daughter Because of the Client’s Confusion

Taking the history from the daughter might seem practical due to the client’s confusion, but it is not the best approach in this case. The daughter’s constant interruptions and the client’s reluctance to speak raise concerns about the reliability of the information provided by the daughter. It is crucial to gather information directly from the client whenever possible to ensure an accurate assessment.

Choice D Reason: Interview the Client Alone and Assess for Abuse

Interviewing the client alone and assessing for abuse is the most appropriate intervention. The client’s reluctance to speak and the daughter’s interruptions could indicate that the client is being controlled or intimidated. Conducting a private interview allows the client to speak freely and provides an opportunity to identify any signs of abuse or neglect. Ensuring the client’s safety and addressing any immediate risks is the top priority.