A client who has metastatic bone cancer tells the nurse, “I want to go home to die.” The client’s family is concerned about meeting the client’s care needs at home. Which of the following actions should the nurse take?

A. Use a blow dryer on a moderate heat setting to dry the cast after showering.

This is not recommended as using a blow dryer on a cast can cause burns. Instead, the cast should be allowed to air-dry or be dried with a fan.

B. Use a cotton swab to relieve itching under the cast.

Inserting objects, including cotton swabs, under the cast can lead to complications such as infection or skin damage. It is not recommended to insert anything into the cast.

C. Report any worsening or unrelieved pain.

This is the correct instruction. Persistent or increasing pain can indicate complications such as swelling, infection, or neurovascular compromise. It is important for the client to promptly report any changes in pain to healthcare providers.

D. Avoid moving the affected leg.

While it's important to limit movement to allow for proper healing, complete immobilization can lead to joint stiffness and muscle atrophy. Gentle range-of-motion exercises for non-weight-bearing areas may be encouraged, but any specific movement instructions should be provided by the healthcare provider. If movement causes significant pain or discomfort, the client should consult the healthcare provider.

A. Discuss a referral to home health and hospice care with the client and family.

This is the correct answer. Discussing a referral to home health and hospice care addresses the client's expressed desire to go home and provides the necessary support and care for both the client and the family during this challenging time.

B. Contact the social worker to assist with nursing home placement.

This option may not align with the client's wish to go home. Nursing home placement may not be the preferred choice, especially when the client wants to spend their final days in a home setting.

C. Talk with the provider about extending the client’s hospital stay.

Prolonging the hospital stay may not meet the client's expressed wish to go home and may not provide the same level of comfort and support as home health and hospice care.

D. Instruct the family about meeting the client’s palliative care needs at home.

While providing information about meeting palliative care needs at home is important, it is more comprehensive to involve home health and hospice services, which can provide skilled care, emotional support, and assistance to the family in managing the client's care needs at home.