A nurse responds to the room of a client who is recovering from a cardiac arrest where CPR was performed. The client's child is distraught and tells the nurse that their parent has a do-not-resuscitate (DNR) prescription in their medical record. Which of the following actions should the nurse take first?
Report the occurrence to the nursing supervisor,
Complete an incident report stating the facts of the situation.
Verify the DNR prescription is current in the medical record.
Request a meeting with the ethics committee.
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. The statement "The costs associated with complications after a surgical procedure are factored into the scheduled reimbursement" is incorrect. Complications after a surgical procedure may lead to increased costs, but these costs are not always fully reimbursed. Preventing complications is a key strategy to control costs, as it can reduce the need for additional resources and interventions.
B. The statement "Charging the client for only a portion of the supplies used will help to decrease the costs to the hospital" is not a sustainable or ethical approach to cost containment. Proper billing practices and transparency are essential in healthcare, and passing on costs to clients in an arbitrary manner can lead to ethical and legal issues.
C. The statement "A high cost of treatment ensures that the best quality of care was provided to the client" is incorrect. While high-quality care is important, high costs do not necessarily guarantee quality. Cost-effectiveness and efficiency in healthcare delivery are critical considerations to ensure quality care without unnecessary expenses.
D. The statement "Client care should be organized for efficient use of time" is correct. Efficient organization of client care helps optimize resources, reduce unnecessary delays, and enhance overall productivity. Streamlining processes and workflow contributes to effective cost containment within a healthcare facility.
Correct Answer is A
Explanation
A. Repositioning the client by log-rolling is a critical intervention after lumbar laminectomy surgery. Log-rolling involves turning the entire body as a unit to prevent twisting or bending at the waist, which can strain the surgical site and potentially cause injury. This method helps protect the spine and maintain alignment during movement.
B. Placing a pillow under the client's back while supine is generally not recommended after a lumbar laminectomy. It may cause hyperextension of the spine, leading to discomfort and potential strain on the surgical site.
C. Removing the back brace when the client is out of bed is not a standard practice without specific orders from the surgeon. Back braces are often prescribed for support and stabilization during movement, especially in the early postoperative period.
D. Maintaining the head of the bed at 90° is not advisable after a lumbar laminectomy. The positioning of the bed should be individualized based on the surgeon's preferences, but typically, keeping the bed flat or in a slightly elevated position is more appropriate to reduce strain on the surgical site.
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