A hospice nurse is caring for a client who is approaching death and has fecal incontinence. Which of the following actions should the nurse take?

Request a prescription for lactulose from the provider.

Place an occlusive dressing over the client's buttocks every 8 hr.

Insert a lubricated rectal tube gently.

Keep disposable undergarments clean and dry.

Answer and Explanation

The Correct Answer is D

A. Request a prescription for lactulose from the provider: Lactulose is a laxative commonly used to treat constipation, but it is not appropriate for managing fecal incontinence in a hospice client approaching death. It focuses on promoting bowel movements rather than managing incontinence.

B. Place an occlusive dressing over the client's buttocks every 8 hr: Occlusive dressings are not typically used for managing fecal incontinence. They may trap moisture and exacerbate skin breakdown, especially in a hospice client who may be immobile or bedridden.

C. Insert a lubricated rectal tube gently: Inserting a rectal tube is invasive and may cause discomfort or injury, especially in a client who is approaching death. It is not recommended for managing fecal incontinence in this situation.

D. Keep disposable undergarments clean and dry: This is the most appropriate action for managing fecal incontinence in a hospice client. Keeping disposable undergarments clean and dry helps maintain skin integrity and prevents skin breakdown and discomfort. It also promotes comfort and dignity for the client during this sensitive time.

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Correct Answer is C

Explanation

A. Obituary: An obituary is a notice of a person's death, typically including a brief biography and details of the funeral arrangements. It is a written announcement or notice of someone's passing, usually published in newspapers or online. Obituaries do not involve the examination of body organs and tissues after death; rather, they serve as a tribute to the deceased.

B. Postmortem care: Postmortem care refers to the care provided to the body of a deceased person, including cleaning, preparing for viewing, and ensuring dignity in handling. It involves activities such as bathing, dressing, and positioning the body. Postmortem care does not involve the examination of body organs and tissues for diagnostic or investigative purposes.

C. Autopsy: An autopsy is the examination of a body after death to determine the cause of death or to study the extent and nature of disease processes. It involves a thorough examination of body organs and tissues, often including dissection and analysis under a microscope. Autopsies are performed by pathologists and are typically ordered by medical examiners, coroners, or physicians to gather information about the circumstances surrounding a person's death.

D. Transplant: Transplantation involves the surgical removal of an organ or tissue from one person (the donor) and its transfer to another person (the recipient) to replace a damaged or failing organ. Transplants are performed while the donor is alive (living donor) or after death (deceased donor). However, the examination of body organs and tissues after death is not specifically related to the transplant process.

A. the patient has a doctor Who does not tell patients when they have a terminal illness. B. the patient is in denial and is unable to consciously admit what he has been told by the doctor. C. the patient needs to be told that he doesn’t have long to live so that he can make his final arrangements. D. she will have to avoid all conversation that refers to his disease or symptoms so as not to increase his anxiety.

Correct Answer is B

Explanation

A. This option assumes that the doctor does not inform patients about terminal illnesses, which may not necessarily be the case. It is more likely that the patient is in denial rather than the doctor not disclosing the diagnosis.

B. Denial is a common defense mechanism in response to distressing or overwhelming information. The patient's statement suggests denial of the terminal diagnosis despite being informed by the doctor. Denial allows individuals to avoid confronting the reality of their situation and can serve as a protective mechanism to cope with the emotional impact of the diagnosis.

C. While it may be important for the patient to have an understanding of their prognosis in order to make informed decisions and final arrangements, pushing the patient to accept the reality of their terminal illness before they are ready may not be helpful and can cause distress.

D. Avoiding conversation about the disease or symptoms may not address the underlying issue of denial and may hinder open communication between the patient and healthcare team. It is important for the nurse to provide support and opportunities for the patient to discuss their feelings and concerns about their illness, while also respecting their coping mechanisms.

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A hospice nurse is caring for a client who is approaching death and has fecal incontinence. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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