A client who has a terminal illness asks the nurse, "If I have a DNR prescription, does that mean I will no longer receive any treatment for my condition?"
Which of the following statements should the nurse provide to explain a DNR prescription?
A DNR prescription means you will only receive pain medication for your treatments.
A DNR prescription will limit your current treatment regimen.
A DNR prescription will allow you to continue with your current treatment regimen.
A DNR prescription will limit your ability to receive invasive procedures.
The Correct Answer is C
Choice A reason: The statement that a DNR prescription means the client will only receive pain medication is incorrect. A DNR (Do Not Resuscitate) order does not affect the provision of treatments other than those required to resuscitate the patient if their heart stops or they stop breathing. Patients with a DNR can still receive all other medical treatments and interventions aimed at managing symptoms and improving quality of life, including pain management.
Choice B reason: A DNR prescription does not limit the current treatment regimen in terms of ongoing treatments for the patient's condition. The DNR order specifically refers to not performing CPR (cardiopulmonary resuscitation) if the patient's breathing or heart stops. All other aspects of the patient's care plan, including aggressive treatments, can continue if they align with the patient's wishes and medical advice.
Choice C reason: This is the correct statement. A DNR prescription allows the patient to continue with their current treatment regimen. It is a directive that applies only in the event of cardiac or respiratory arrest, indicating that CPR should not be performed. However, it does not preclude the patient from receiving other medical treatments or interventions.
Choice D reason: A DNR prescription does not inherently limit the ability to receive invasive procedures. The decision to pursue or avoid invasive procedures would be based on the patient's overall treatment goals, prognosis, and personal preferences, not solely on the presence of a DNR order.
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Related Questions
Correct Answer is B
Explanation
Choice A reason: The statement "You should limit discussing past events with the client" does not necessarily incorporate the client's and family's cultural beliefs. Discussing past events can be a part of reminiscence therapy, which can be beneficial for clients with terminal illnesses. It allows them to reflect on their life experiences and can provide a sense of fulfillment or closure.
Choice B reason: Saying "We will respect what is important to you" is a broad and inclusive statement that acknowledges the importance of the client's and family's cultural beliefs. It implies that the care team is willing to listen and adapt the care plan to align with the client's values, which is a fundamental aspect of culturally competent care. This approach can help ensure that the client's end-of-life care is respectful and responsive to their individual needs.
Choice C reason: Offering to "arrange all burial services" may not be appropriate as it assumes that the family requires assistance with this aspect of care without first understanding their specific cultural or religious practices. It is important to have a conversation with the client and family about their preferences and needs regarding end-of-life rituals before making any arrangements.
Choice D reason: The statement "Grieving should not be done in front of the client" may not align with the cultural beliefs of the client and family. Grieving practices vary widely among different cultures, and some may find it important to express grief openly in the presence of the dying person. It is essential to respect and accommodate the family's grieving process.
Correct Answer is D
Explanation
Choice A reason: Gurgling bowel sounds every 10 seconds are considered normal, as normoactive bowel sounds range from 5 to 30 sounds per minute. This finding indicates regular gastrointestinal activity and is not typically a cause for concern.
Choice B reason: A centrally located umbilical protrusion can be a normal finding, especially if it has been present since birth and is not associated with any other symptoms. However, if new or associated with pain or other symptoms, it could indicate a hernia or other pathology.
Choice C reason: Abdominal distention during breathing can be a normal finding, as the abdomen may distend slightly during deep breathing due to the movement of the diaphragm. However, if the distention is pronounced or associated with other symptoms, it may warrant further investigation.
Choice D reason: Rebound tenderness with palpation is a sign of peritoneal irritation and can be an indication of conditions such as appendicitis, which is a surgical emergency. This finding should be considered a priority as it may require immediate intervention.
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