A nurse is caring a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client’s feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?
“You should contact the provider about your wishes to your family member.”
“You should speak with the facility’s ethics committee about your concerns.”
“We’ll need to have the nursing supervisor review the client’s advance directives.”
“As the health care surrogate, the client’s partner can make this decision.”
The Correct Answer is D
a. "You should contact the provider about your wishes for your family member."
While the provider may ultimately be involved in decision-making, it's important for the nurse to address the conflicting wishes and provide guidance on the appropriate steps to take in such situations.
b. "You should speak with the facility’s ethics committee about your concerns."
In cases of conflicting wishes or ethical dilemmas, involving the ethics committee can be beneficial. However, this response might not address the immediate need for clarification and guidance.
c. "We’ll need to have the nursing supervisor review the client’s advance directives."
Reviewing advance directives with the nursing supervisor is a reasonable step to ensure that the client's wishes are documented and followed. However, it might not directly address the conflicting wishes or provide immediate resolution.
d. "As the health care surrogate, the client’s partner can make this decision."
This is the correct response. The health care surrogate, appointed by the client or legally recognized as such, has the authority to make medical decisions on behalf of the unconscious client. It's important to follow the client's advance directives and legal designations regarding
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Related Questions
Correct Answer is B
Explanation
a. Administer a sedative to the client:
Administering a sedative may temporarily calm the client, but it should not be the first-line intervention, especially without a physician's order. Sedatives carry risks and should only be used when other interventions have been considered and deemed ineffective or when the client's behavior poses an immediate danger to themselves or others.
b. Contact a family member to come and sit with the client: could indeed be a valid first step. If a family member is available and able to assist, they could potentially calm the client without the need for isolation and reducing disruptive behavior.However, if this is not feasible, then ensuring the client’s safety through temporary isolation with frequent checks might be necessary.
c. Place the client in a wheelchair with a lap tray:
Placing the client in a wheelchair with a lap tray may restrict their movement and potentially exacerbate agitation or aggression. It does not address the underlying reasons for the behavior and may not be an appropriate intervention for managing wandering behavior.
d. Keep the client in her room with the door closed:
Isolating a client in their room could be considered a form of restraint or isolation and should be used with caution.This should be used only after other less restrictive measures have been tried and deemed ineffective.
Correct Answer is A
Explanation
a. A client who has an asymmetrical thorax:
An asymmetrical thorax can indicate a potentially life-threatening condition such as a tension pneumothorax, hemothorax, or flail chest. These conditions can compromise respiratory function and require immediate intervention to ensure the client's airway and breathing are maintained.
b. A client who has an open fracture of the femur:
An open fracture of the femur is a serious injury that requires prompt attention to prevent complications such as infection and excessive blood loss. However, it is typically classified as urgent rather than emergent unless there are signs of significant hemorrhage or compromised perfusion that threaten life.
c. A client who has preorbital edema:
Preorbital edema, which is swelling around the eyes, can be concerning and requires evaluation but is not typically life-threatening. This condition is less likely to require immediate intervention compared to compromised airway or breathing issues.
d. A client who has a deep-partial thickness burn on the lower extremities:
Deep-partial thickness burns are serious and painful injuries that require medical attention. However, they are usually not immediately life-threatening unless they involve a large percentage of body surface area or are accompanied by other critical injuries or complications. They are often categorized as urgent rather than emergent.
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