A nurse is caring for four clients. Which of the following assessment findings is the priority?

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:

Reporting the findings to the hospital ethics committee is not the appropriate action in this scenario. Ventilator-associated pneumonia (VAP) is a clinical issue related to patient care and safety, not an ethical concern. The hospital ethics committee is generally responsible for addressing ethical dilemmas and conflicts.

Choice B rationale:

Alerting central supply is not the correct action in this situation. Central supply typically handles the procurement and distribution of medical supplies, equipment, and materials. While maintaining proper equipment and supplies is important, addressing VAP requires a focus on infection prevention and patient care practices.

Choice C rationale:

Filling out an incident report is not the best course of action for addressing an increase in ventilator-associated pneumonia. Incident reports are typically used to document unexpected events, accidents, or errors that occur in the healthcare setting. However, addressing the rise in VAP involves implementing measures to prevent and control infections, which falls under the purview of the quality improvement team.

Choice D rationale:

The correct action is to notify the quality improvement team. Ventilator-associated pneumonia is a healthcare-associated infection that can lead to serious complications for patients on ventilators. The quality improvement team is responsible for monitoring and improving the quality of patient care, including infection prevention and control. By notifying the quality improvement team, the nurse manager can initiate a comprehensive review of current practices, identify potential areas for improvement, and implement evidence-based interventions to reduce the incidence of VAP.