A nurse is caring for a client who is comatose. The client has a living will that declines the use of artificial enteral nutrition as a life-sustaining measure, but the client's family has requested that the staff begin tube feedings. Which of the following actions should the nurse take?

Choice A rationale:

Involving the client's parents in treatment decisions might not be appropriate if the client does not want them involved. Furthermore, the client's autonomy and wishes should be respected, and decisions about treatment should be primarily based on the client's preferences.

Choice B rationale:

This is the correct response. The nurse should respect the client's decision to discontinue chemotherapy and provide information about palliative care as an alternative option. Palliative care focuses on symptom management and improving the client's quality of life, aligning with the client's wishes to stop chemotherapy.

Choice C rationale:

Contacting the spiritual advisor is not directly related to the client's expressed desire to discontinue chemotherapy. While spiritual and emotional support are important, the primary concern here is addressing the client's medical decisions.

Choice D rationale:

Contacting the client's parents to discuss durable power of attorney is not appropriate if the client does not want them involved in the decision-making process. The client's autonomy and preferences should be respected, and they should be empowered to make their own medical decisions.

Choice A rationale:

Informing the staff of the penalties that can result from medication errors represents an authoritarian approach to managing the issue. This approach relies on authority and fear to enforce compliance. By emphasizing the potential consequences, the nurse manager is attempting to control behavior through fear of punishment. While this might create a short-term change in behavior, it does not address the root causes of the errors or promote a culture of safety.

Choice B rationale:

Encouraging the staff to have two nurses verify medication orders to prevent errors is not an authoritarian approach. It involves collaboration and peer support to enhance medication safety. This approach promotes shared responsibility and accountability, which are not associated with authoritarian leadership.

Choice C rationale:

Providing a suggestion box for the staff to submit ideas for error prevention is not an authoritarian approach. This strategy fosters a participative and democratic leadership style. It encourages staff engagement and input, which contrasts with the top-down nature of authoritarian leadership.

Choice D rationale:

Asking three experienced nurses to help investigate common causes of the errors is not an authoritarian approach. It involves a collaborative and problem-solving approach that seeks input from knowledgeable staff members. This approach aims to identify systemic issues contributing to errors rather than focusing solely on punitive measures.