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Fundamentals of Nursing

What Should the Nurse Do?

Fundamentals of NursingWhat Should the Nurse Do?

What Should the Nurse Do?

1 .
The nurse is caring for a 65-year-old patient who has recently entered hospice with a diagnosis of advanced muscular dystrophy. The patient states that his pain is terrible and that he needs more medication. The family members do not want the patient to be “too sedated.” What education can the nurse provide to meet the needs of both the patient and the family?
2 .
The nurse is caring for an 8-year-old patient with leukemia. The mother speaks to the nurse privately and begins crying as she expresses her guilt for not being available to her other children and her need to stay with her sick child. What next steps can the nurse take to help this mother?
3 .
A nurse is caring for a patient and family in an in-patient hospice unit. After the patient’s death, the wife is reluctant to leave the bedside in order for the nurse to perform postmortem care. Her daughters are encouraging her to leave the room. How should the nurse respond?
Nurse Bree is working in a medical unit in a hospital. One of her patients is an 83-year-old patient with end-stage kidney failure; she receives dialysis regularly and has recently decided to pursue more comfort care options. Despite her end-stage disease, she has not completed any advance care planning. Bree feels she should address this topic with the patient and her daughter. Bree’s other patient is a 24-year-old patient who was diagnosed with type 1 diabetes ten years ago. He has been hospitalized with diabetic ketoacidosis (DKA) multiple times since his diagnosis. Looking through his chart, she noticed he had a signed DNR order. Bree is shocked when she sees this order and initially feels compelled to discuss it with her colleagues and the patient’s provider.
4 .
What factors likely affect Bree’s reaction to the advance planning orders for these two patients?
5 .
As Bree cares for these patients, what support can she get in discussing the topic of advance planning with these patients? How can Bree care for these patients if she disagrees with their choices?
6 .
How should Bree explain the difference between comfort care and DNR to these patients?
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