Which information should the practical nurse (PN) collect during the admission assessment of a terminally ill client to an acute care facility?
Health care proxy documentation.
Name of funeral home to contact.
Client's wishes regarding organ donation.
Contact information for the client's next of kin.
The Correct Answer is A
- A terminally ill client is a client who has a progressive and incurable disease or condition that is expected to result in death within a short period of time, such as months or weeks. A terminally ill client may require palliative care, which is the care that focuses on relieving pain and suffering and improving the quality of life for the client and their family.
- An admission assessment is the process of collecting information about a client's health status, needs, preferences, and goals when they are admitted to a health care facility, such as a hospital, nursing home, or hospice. An admission assessment helps to establish a baseline for the client's condition, plan and implement appropriate interventions, and evaluate the outcomes of care.
- A health care proxy is a legal document that allows a client to appoint another person, such as a family member or a friend, to make health care decisions for them if they become unable to do so themselves. A health care proxy may also include specific instructions or preferences about the type and extent of care that the client wishes to receive or refuse, such as life-sustaining treatments, resuscitation, or organ donation.
- Health care proxy documentation is important information that the practical nurse (PN) should collect during the admission assessment of a terminally ill client to an acute care facility, as it reflects the client's autonomy, dignity, and wishes regarding their end-of-life care. It also helps to ensure that the client's healthcare decisions are respected and followed by the healthcare team and the facility.
- Therefore, option A is the correct answer, while options B, C, and D are incorrect.
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Correct Answer is C
Explanation
This is the correct answer because it is the most important and relevant action that the PN should do for a postoperative patient with a PCA machine. A PCA machine is a computerized device that allows the patient to self-administer a preset dose of pain medication, usually an opioid, by pressing a buton. The PCA machine is attached to an intravenous (IV) line that delivers the medication directly into the bloodstream. The PCA machine can provide effective and individualized pain relief for postoperative patients, as well as increase their sense of control and satisfaction¹².
The PN should assess the pain management response of the postoperative patient with a PCA machine by monitoring their pain level, vital signs, oxygen saturation, sedation level, and side effects. The PN should use a valid and reliable pain scale, such as the numeric rating scale (NRS) or the visual analog scale (VAS), to measure the patient's pain intensity and relief. The PN should also check the settings and functioning of the PCA machine, such as the dose, lockout interval, and limit. The PN should document and report the patient's pain management response and any problems or complications with the PCA machine to the health care provider.
Correct Answer is D
Explanation
Pilocarpine ophthalmic drops are used to treat glaucoma by reducing intraocular pressure. They do not have an anesthetic effect and are not used for the purpose of numbing or anesthetizing the eyes. It is important for the client to have a correct understanding of the medication and its intended use.
Here's why the other options are incorrect:
A. Reassure the client that the drops will not be needed often since eye pain in glaucoma is not common: This statement is not accurate. While eye pain may not be a common symptom of glaucoma, pilocarpine drops are primarily used to reduce intraocular pressure, not to address eye pain.
B. Reteach the client about the action of the eye drops to decrease pressure in the eyes: This option may be considered if the client misunderstood the information initially, but it is not the most appropriate response in this scenario. The client's statement indicates a specific belief about the drops providing anesthetic effects, so clarifying the purpose of the drops is more appropriate.
C. Document in the chart that the client understands the action and use of the eye drops: Documentation is important, but in this case, it is necessary to address the client's misconception about the anesthetic effect of the drops and provide accurate information.
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