A nurse is caring for a client who has gone into cardiac arrest. The client's chart indicates refusal of life-sustaining measures in a living will signed 10 years ago, but a do-not-resuscitate (DNR) prescription has not been written by the provider. Which of the following actions by the nurse is appropriate?
Contact the provider for instructions regarding a DNR.
Consult with the client's family regarding resuscitation efforts.
Comply with the living will and let the client expire naturally.
Call a code because a DNR prescription has not been written.
The Correct Answer is D
A. Contacting the provider for instructions could delay immediate resuscitative efforts, which are required in the absence of a DNR order.
B. Consulting with the client’s family may not be effective in an emergency, as the living will is a legal document, and family members cannot override it without a DNR order.
C. Complying with the living will and letting the client expire naturally would be inappropriate without a formal DNR order in place.
D. Calling a code is the correct action because, legally, resuscitative efforts must be initiated in the absence of a written DNR order from the provider, despite the existence of a living will.
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Correct Answer is B
Explanation
A. While connecting the client with others may provide support, it does not directly address the client’s frustrations or concerns about their therapy.
B. Asking the provider to speak with the client directly can facilitate communication about their concerns and may help address their frustrations regarding the plan of care.
C. Threatening the client with consequences for leaving is not appropriate and may increase their frustration and disengagement from care.
D. It is important to respect the client’s autonomy and right to leave, so informing them they cannot leave is not appropriate or legal without proper discharge procedures being followed.
Correct Answer is D
Explanation
A. Establishing the priorities of client care is part of the planning phase, not the implementation phase.
B. Comparing laboratory values is an assessment activity that occurs before planning and implementing care.
C. Asking the client about pain is an assessment activity used to gather information rather than an implementation task.
D. Reinforcing teaching about the client's diagnosis is an action that occurs during the implementation phase, as it involves executing the care plan and providing direct client education.