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:
Get him out of bed for an hour in the morning and afternoon and for a short time (15 minutes) before bedtime so that he does not sleep all day and stay awake at night.
Get him out of bed for 2 hours in the morning and afternoon and for a short time (15 minutes) before bedtime so that he does not sleep all day and Stay awake at night.
Assess his strength and desire to get out of bed, but permit him to remain in bed if he chooses, because that is his position of comfort.
Leave him in bed if he wishes, but have him do active exercises of his legs and arms to prevent further muscle weakness.
The Correct Answer is C
A. and B. Both options involve getting the patient out of bed for specified periods during the day to prevent excessive sleep during the day and wakefulness at night. However, these options may not align with the patient's preferences and comfort.
C. This option respects the patient's autonomy and acknowledges his preference to remain in bed due to feeling tired and weak. It also recognizes that comfort is a priority in end-of-life care. The nurse will assess the patient's strength and desire to get out of bed but will permit him to remain in bed if he chooses, as that is his position of comfort.
D. Leaving the patient in bed while encouraging active exercises may be physically demanding for the patient and may not be appropriate, especially considering the patient's terminal condition and desire to remain in bed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Hospice care does not exclude hospital care entirely. While the primary focus is on providing care in the patient's preferred setting, whether it be at home, in a nursing facility, or in a hospital, hospice services can extend to these settings as needed.
B. Hospice care does aim to provide comfort and support to patients at the end of life, but it does not focus on hastening death. Instead, it emphasizes enhancing the quality of life and ensuring comfort during the dying process, whether at home or in another setting chosen by the patient.
C. Hospice does not support assisted suicide or euthanasia. Its primary goal is to provide holistic care and support to patients and their families during the end-of-life period while upholding the patient's dignity and autonomy.
D. Hospice philosophy emphasizes symptom management and comfort care as its primary focus. The goal is to enhance the quality of life for terminally ill patients by addressing physical, emotional, and spiritual needs while supporting both the patient and their family through the dying process.
Correct Answer is A
Explanation
A. "I am hoping this will help relieve my discomfort": This statement reflects an understanding of the palliative nature of the care the client is receiving. The client acknowledges the goal of palliative care, which is focused on symptom management and improving quality of life rather than curative treatment. By expressing hope for relief from discomfort, the client demonstrates acceptance of the prognosis and is aligning with the goals of palliative care.
B. "This is not working, and I plan to stop treatment" : This statement suggests frustration with the current treatment but does not necessarily indicate acceptance of the prognosis. The client may still be seeking alternative treatments or may not fully understand the terminal nature of their condition.
C. "This is making me stronger every day": This statement implies a belief in the effectiveness of the treatment and a focus on improvement rather than acceptance of the prognosis. It does not address the client's understanding of their condition or prognosis.
D. "I am thinking of getting a second opinion": This statement indicates that the client is considering alternative perspectives on their diagnosis and treatment plan. While seeking a second opinion is a valid decision, it does not necessarily reflect acceptance of the prognosis. It suggests a desire for further information or clarification rather than a recognition of the terminal nature of the illness.
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