A nurse is preparing for a home visit with a client who is postoperative following an above-the-knee amputation. Which of the following questions should the nurse plan to ask first?

A. Perform CPR on the client:

CPR (Cardiopulmonary Resuscitation) is a critical and time-sensitive intervention during a cardiac arrest. An assistive personnel trained in CPR can initiate chest compressions while awaiting further medical assistance.

B. Assist with airway intubation:

Airway intubation is a more advanced skill typically performed by healthcare providers such as physicians or advanced practice nurses. It is beyond the scope of practice for most assistive personnel.

C. Maintain IV access:

Maintaining IV access may require specific skills and knowledge about medications and fluids. While some assistive personnel may be trained in certain aspects of IV care, the level of expertise needed during a cardiac arrest may be beyond their scope.

D. Place defibrillator pads on the client:

Applying defibrillator pads involves handling medical equipment and making critical decisions about when to deliver a shock. This task is typically performed by healthcare providers trained in advanced cardiac life support (ACLS).

A. Report the occurrence to the nursing supervisor:

While reporting the occurrence is important, verifying the DNR status takes precedence. The nurse needs to gather information and confirm whether the patient has a current DNR order before escalating the issue to a higher authority.

B. Complete an incident report stating the facts of the situation:

Completing an incident report is a part of the process, but it should not be the first action. The immediate concern is to determine if the patient has a valid DNR order. An incident report can be completed later to document the situation and any actions taken.

C. Verify the DNR prescription is current in the medical record.

Verifying the DNR (do-not-resuscitate) prescription is the first and most immediate action the nurse should take. It is crucial to confirm the current status of the DNR order to ensure that the healthcare team is following the patient's wishes. If the DNR is indeed valid and up-to-date, it means the resuscitation efforts, including CPR, were contrary to the patient's expressed wishes.

D. Request a meeting with the ethics committee:

Contacting the ethics committee may be necessary depending on the circumstances, but it is not the first step. Verifying the DNR status is an immediate action that can guide subsequent decisions. If there are ethical concerns or conflicts, involving the ethics committee can be considered after confirming the facts surrounding the DNR order.