Nokea
Which interventions can the nurse use to facilitate communication with patients and families who are in the process of making decisions regarding end- of-life care options? (Select all that apply.)
- A. Communication of uniform messages from all healthca re team members
- B. An integrated plan of care that is developed collaborat ively by the patient, family, and healthcare team
- C. Facilitation of continuity of care through accurate shift -to-shift and transfer reports
- D. Limitation of time for families to express feelings in order to control family grief
Correct Answer: A
Rationale: The correct answer is A: Communication of uniform messages from all healthcare team members. This intervention is crucial to ensure consistency in information provided to patients and families, reducing confusion and enhancing trust. When all team members convey the same messages, it helps in clarifying options and facilitating decision-making.
Choices B and C are incorrect as they focus on care planning and continuity, which are important but not specifically related to facilitating communication in end-of-life care decisions. Choice D is incorrect as it suggests limiting time for families to express feelings, which can hinder effective communication and support during such a sensitive time.
You may also like to solve these questions
The charge nurse is supervising the care of four critical ca re patients being monitored using invasive hemodynamic modalities. Which patient should t he charge nurse evaluate first?
- A. A patient in cardiogenic shock with a cardiac output (CabOirb). coofm 2/te.0st L/min
- B. A patient with a pulmonary artery systolic pressure (PA P) of 20 mm Hg
- C. A hypovolemic patient with a central venous pressure (CVP) of 6 mm Hg
- D. A patient with a pulmonary artery occlusion pressure (PAOP) of 10 mm Hg
Correct Answer: A
Rationale: The correct answer is A because the patient in cardiogenic shock with a cardiac output of 2.0 L/min is experiencing a life-threatening condition that requires immediate evaluation. Cardiogenic shock indicates poor cardiac function, which can lead to multi-organ failure. Monitoring cardiac output is crucial in managing these patients.
Choice B is incorrect because a pulmonary artery systolic pressure of 20 mm Hg is within normal range and does not indicate an immediate life-threatening condition.
Choice C is incorrect because a CVP of 6 mm Hg in a hypovolemic patient may indicate volume depletion, but it is not as urgent as the patient in cardiogenic shock.
Choice D is incorrect because a PAOP of 10 mm Hg is within normal range and does not suggest an immediate critical condition.
When preparing to cool a patient who is to begin therapeutic hypothermia, which intervention will the nurse plan to do (select all that apply)?
- A. Assist with endotracheal intubation.
- B. Insert an indwelling urinary catheter.
- C. Begin continuous cardiac monitoring.
- D. Obtain an order to restrain the patient.
Correct Answer: C
Rationale: Rationale:
Continuous cardiac monitoring is crucial during therapeutic hypothermia to monitor the patient's cardiac rhythm and detect any arrhythmias promptly. This intervention allows for immediate intervention if any cardiac issues arise.
Explanation of other choices:
A: Assisting with endotracheal intubation may be necessary for airway management but is not directly related to cooling the patient for therapeutic hypothermia.
B: Inserting an indwelling urinary catheter may be needed for urine output monitoring but is not a priority intervention for cooling the patient.
D: Restraining the patient is unnecessary and not indicated for therapeutic hypothermia; it may cause unnecessary distress and should be avoided unless absolutely necessary for patient safety.
A patient is experiencing severe pain, despite receiving pain medication for the past 24 hours. The patients wife expresses concern about this to the nurse. Which response by the nurse would be most empowering to the patients family?
- A. Explain that the doctor is an expert on pain medication and that the current level ofm edication is the best.
- B. Recommend that the family members take turns massaging the patients feet todistract from the pain.
- C. Encourage the family to request that the physician evaluate the patients pain control.
- D. Ask the family to wait another 24 hours to see whether the patients pain level will go down.
Correct Answer: C
Rationale: The correct answer is C because it empowers the family to take action by requesting a physician evaluation of the patient's pain control. This step is crucial in ensuring that the patient's pain is adequately managed. By involving the physician, the family can advocate for the patient's needs and potentially explore alternative pain management strategies.
Choice A is incorrect because it dismisses the family's concerns and fails to address the need for further evaluation. Choice B may provide temporary relief but does not address the underlying issue of inadequate pain control. Choice D is incorrect as it suggests delaying action, which could lead to prolonged suffering for the patient.
After attending an educational program, the nurse understaanbidrbs.c othma/tte swt hich the following situations would require an ethics consultation?
- A. Conflict has occurred between the primary care provid er and family regarding treatment decisions. A family conference is held, and the family and primary care provider agree to a treatment plan that includes aggres sive treatment for 24 hours followed by re-evaluation.
- B. Family members disagree as to a patient’s course of tre atment. The patient has designated a healthcare proxy and has a written advancaebi rdb.icroemc/tteivste .
- C. A postoperative coronary artery bypass surgery patient was successfully resuscitated after sustaining a cardiopulmonary arrest i n the operating room The patient who is now not responding to treatment has a written advance directive and has a life partner at the bedside.
- D. Patient with multiple trauma and is not responding to treatment. No family members are known, and care is considered futile.
Correct Answer: D
Rationale: Step 1: The correct answer is D because the situation involves a patient with multiple trauma who is not responding to treatment and has no known family members. This indicates a complex ethical dilemma where the medical team may be unsure about the appropriate course of action.
Step 2: In this scenario, an ethics consultation is necessary to help guide decision-making regarding the care of the patient. The lack of available family members complicates decision-making, and the consideration of care as futile adds another layer of complexity.
Step 3: An ethics consultation can provide a structured framework for evaluating the situation, considering ethical principles such as beneficence, non-maleficence, autonomy, and justice. It can help the healthcare team navigate the ethical considerations and make a well-informed decision in the best interest of the patient.
Summary:
Choice A: While conflicts between the primary care provider and family may warrant discussions, the agreement on a treatment plan does not necessarily require an ethics consultation.
Choice B: Disagreement
What is an early signs of the effect of hypoxemia on the nervous system?
- A. Cyanosis
- B. Restlessness
- C. Tachycardia
- D. Tachypnea
Correct Answer: B
Rationale: The correct answer is B: Restlessness. When the body experiences hypoxemia (low oxygen levels), the brain is deprived of oxygen, leading to early signs such as restlessness. This is due to the brain's attempt to increase oxygen intake by increasing activity. Cyanosis (A) is a late sign of hypoxemia when oxygen levels are critically low. Tachycardia (C) and tachypnea (D) are compensatory mechanisms in response to hypoxemia, but they are not early signs affecting the nervous system directly.