A nurse is providing palliative care to a client who is receiving hospice care and is approaching death. Which of the following actions should the nurse take? (Select all that apply.)

Do not force the client to stay awake

Administer pain medication by rectal or transdermal when client can no longer swallow

Position the client on her side

Offer to turn and reposition client every 2 hours

Answer and Explanation

Correct Answer : A,B,C,D

A. Do not force the client to stay awake: Palliative care focuses on providing comfort and dignity to the patient, and forcing the client to stay awake would not align with this goal. Allowing the client to rest as needed is essential for maintaining comfort during the end-of-life process.

B. Administer pain medication by rectal or transdermal when client can no longer swallow: As the client approaches death, they may lose the ability to swallow oral medications. Administering pain medication rectally or via transdermal patches ensures that the client continues to receive adequate pain relief even when oral intake is no longer possible.

C. Position the client on her side: Positioning the client on her side helps prevent aspiration if there is vomiting and promotes comfort by reducing pressure on bony prominences. This position also facilitates effective airway management and can help alleviate respiratory distress.

D. Offer to turn and reposition client every 2 hours: Turning and repositioning can help prevent pressure ulcers and maintain skin integrity, during the terminal stage of illness. The frequency of turning and repositioning may be adjusted based on the client's comfort and clinical condition.

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Correct Answer is E

Explanation

A. Anger: Anger typically involves feelings of frustration, resentment, or hostility towards others or the situation. The behavior described in the scenario does not express anger towards anyone or anything but rather attempts to negotiate or make deals in hopes of changing the outcome.

B. Acceptance: Acceptance involves coming to terms with the reality of the situation and finding peace with it. The behavior described does not indicate acceptance but rather a desire to alter the situation through bargaining.

C. Depression: Depression involves feelings of sadness, hopelessness, and despair. While the behavior described may indicate emotional distress, it is more reflective of bargaining rather than depression.

D. Denial: Denial is characterized by refusing to accept the reality of the situation. The behavior described involves acknowledging the situation but attempting to change it through bargaining, indicating a stage beyond denial.

E. Bargaining: Bargaining is a stage where individuals attempt to negotiate or make deals to change the outcome of a situation. The behavior described in the scenario, pleading in exchange for a desired outcome, aligns with the bargaining stage of Kübler-Ross's stages of dying.

A. IV fluids or tube feeding would likely make the patient more uncomfortable, and dehydration has been shown to decrease pain and discomfort. B. Once the patient is unconscious, his health care proxy can order IV fluids or tube feedings to prevent dehydration. C. IV fluids or a tube feeding would make the patient much more comfortable, and they should try to talk him into accepting them. D. dehydration is painful, and medication can be given to overcome any pain.

Correct Answer is A

Explanation

A. This response aligns with best practices in hospice care, which prioritize comfort and quality of life for terminally ill patients. Dehydration is a common occurrence at the end of life and is generally not associated with discomfort when managed appropriately. IV fluids or tube feedings may cause discomfort, contribute to fluid overload, or lead to complications such as aspiration pneumonia.

B. While the healthcare proxy may have the authority to make decisions on behalf of the patient, the focus should be on honoring the patient's wishes as expressed in advance directives. If the patient has clearly indicated a preference against IV fluids or tube feedings in their advance directives, this should be respected.

C. Encouraging the family to try to talk the patient into accepting IV fluids or tube feedings goes against the principles of patient autonomy and informed decision-making. The decision regarding medical interventions should be based on the patient's preferences and comfort.

D. While dehydration can be uncomfortable in some circumstances, providing adequate symptom management, including pain medication, is essential in hospice care. However, IV fluids or tube feedings are not typically used to manage dehydration in patients who are at the end of life, as they may not improve comfort and can lead to complications.

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A nurse is providing palliative care to a client who is receiving hospice care and is approaching death. Which of the following actions should the nurse take? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. pleads "If Mom will just be OK. I'll do my homework every day."

Correct Answer is E

Explanation

A hospice patient is unable to tolerate food or fluids and has advance directives that indicate that he does not want IV fluids or tube feedings if he is unable to take oral feedings. His family is concerned that he will be very uncomfortable without food or fluids. The nurse should tell them that:

Correct Answer is A

Explanation

A terminal patient in a skilled nursing home has stated that he does not want to get out of bed, because he is too tired and weak to sit in a chair. He sleeps on and off all day and night, his position is changed every 2 hours, and he is comfortable on his pain regimen. The next day the nurse will:

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. Tells God: "If I quit smoking I can just live until after my daughter's wedding."

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. "I'm going after that company for using that chemical on the field next door. "

Directions: Correlate the behavior with KübIer-Ross's stages of dying from the choices below. "Go away, I don't want company. "

The nurse is aware that in order to provide effective support to grieving patients and families, the nurse must?

The emotional feeling of pain and loss is known as

A hospice nurse is caring for a client who is approaching death and has fecal incontinence. Which of the following actions should the nurse take?