A hospice nurse is planning care for a client who is near death. Which of the following actions should the nurse include in the client's plan of care to promote the client's comfort?
Elevate the head of the client's bed.
Offer the client ice chips.
Turn the client every 4 hours.
Provide oral care to the client every 6 hours.
The Correct Answer is A
Choice A reason: Elevating the head of the bed can help ease breathing and promote comfort for a client who is near death. This position can reduce the work of breathing and help prevent aspiration, which is crucial for clients with diminished consciousness or swallowing reflexes.
Choice B reason: Offering ice chips may provide some moisture and comfort to the client, but it is not the primary action to promote comfort for a client who is near death. Ice chips should be used cautiously, especially if the client has difficulty swallowing or is unconscious.
Choice C reason: Turning the client every 4 hours is important to prevent pressure ulcers and promote circulation. However, for a client who is near death, repositioning should be done with consideration for the client's comfort and any pain they may be experiencing.
Choice D reason: Providing oral care every 6 hours can help maintain oral hygiene and comfort, especially if the client is unable to perform this task themselves. It can also help prevent infections and manage any discomfort from dryness or buildup in the mouth.
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Correct Answer is C
Explanation
Choice A reason:While involving a social worker can provide additional support, it is secondary to first communicating the client's treatment decisions to the primary healthcare provider.
Choice B reason: Understanding the client's reasoning is important; however, the priority is to respect their decision and communicate it to the provider.
Choice C reason: Respect for Autonomy: Clients have the right to make informed decisions about their healthcare, including the refusal of treatment.Effective Communication: By discussing the client's wishes with their healthcare provider, the nurse facilitates a collaborative approach to care planning, ensuring that the client's preferences are acknowledged and respected.
Choice D reason: Instructing the client to change their advance directives may be necessary if the client decides to refuse all treatments, but it is not the first action the nurse should take. Understanding the client's wishes should be the priority.
Correct Answer is C
Explanation
A. "I don't want to lose control of my ability to make decisions." This statement reflects a fear of losing autonomy, which is common among individuals with chronic illnesses. While it indicates anxiety and concern about the future, it does not directly suggest suicidal ideation.
B. "I am afraid of experiencing pain near the end." This response shows a fear of suffering and pain, which is also common in terminal illnesses. Although it indicates distress, it does not necessarily imply a risk for suicide.
C. "I know that everything will be better soon." This statement can be a red flag for suicidal ideation, as it may imply that the person believes death is imminent or that they have a plan to end their suffering. It suggests a sense of hopelessness and a potential desire to escape their current situation.
D. "I am relying more and more on my partner for support." This response indicates a need for increased support and dependency on a partner. While it shows a reliance on others, it does not directly suggest suicidal thoughts or intentions.
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