813 CH 44: Loss, Grief, Dying - QUIZ 6

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A client with end-stage chronic obstructive pulmonary disease (COPD) has reached the end of the 6-month period for hospice services and the family caregiver states, "I don't know what we will do if they cut off our hospice services." What is the best response by the hospice nurse? "We can discontinue the service for a period of time and then when your family member gets worse, readmit them." "I will contact the health care provider to extend services since your family member meets the criteria." "Unfortunately, we are unable to continue services past the 6 month period of time." "We can admit your family member to the hospital for treatment and they can reinstate the hospice benefits."

"I will contact the health care provider to extend services since your family member meets the criteria." Explanation: Hospice care is generally provided to clients that have 6 months or less to live, although they are not automatically discharged when they reach 6 months after having been admitted to hospice care. The client may still receive care as long as the health care provider certifies that the client continues to meet the criteria for hospice services. The client should not be admitted to the hospital since the acceptance of palliative comfort care is required to qualify for hospice services. Based on the provided information, there is no need to admit the client to the hospital, and hospital admission may result in termination from the program due to the provision of non-palliative care.

A nurse has just finished a presentation on hospice and palliative care. Which statement by a participant would indicate a need for further education? "Palliative care affirms life and regards dying as a normal process." "In hospice care, nurses take on the responsibility of making care decisions for clients." "Hospice care programs focus on quality rather than length of life." "Palliative care provides relief from pain and other distressing symptoms."

"In hospice care, nurses take on the responsibility of making care decisions for clients." Explanation: The philosophy of hospice is that clients and families are empowered to achieve as much control over their lives as possible. Hospice focuses on relieving symptoms and supporting clients with a life expectancy of 6 months or less, rather than years, and their families. However, palliative care may be given at any time during a client's illness, from diagnosis to end of life. Focuses include pain control, quality of life and normalizing the dying process.

During an interview of the client at the community clinic, the nurse finds that the client is providing care for a parent, who is terminally ill. Which statement by the client indicates anticipatory grieving? "My parent is suffering with cancer and death will be a relief of the pain." "There is no way I can stay in the hospital because my parent is sick." "I do not think my parent really has cancer. I think my parent needs to get a third opinion." "It is fine if my parent dies. We have not been close for years.

"My parent is suffering with cancer and death will be a relief of the pain." Explanation: Anticipatory grief is the characteristic pattern of psychological and physiologic responses a person makes to the impending loss of a significant person. The client's statement, "My parent is suffering with cancer and death will be a relief of the pain," is an example of anticipatory grief and is intended to facilitate coping when death occurs. The client's statement, "There is no way I can stay in the hospital because my parent is sick" demonstrates empathy for the parent and denial of a personal need for treatment. Denial is apparent when the client suggests the parent's diagnosis is incorrect. Denial is also apparent when the client relates it is "fine" if the parent dies because they were not close.

The nurse is caring for a client who recently lost an older adult parent. Which client statement alerts the nurse that the stage of depression may have started within the grief process? "This does not seem real to me." "What am I going to do now that my parent is gone?" "Please go away; I just want to be left alone." "It is all my fault! I did not see the signs."

"Please go away; I just want to be left alone." Explanation: The clinical definition of depression is anxiety and hostility turned inward. The statement asking the nurse to go away and a desire to be "left alone" indicates withdrawal, which is a characteristic of depression. "This does not seem real to me" indicates the client is in denial. Blaming oneself for the loss is an expression of guilt that may occur in the anger phase of grieving. Feeling uncertain about the future may occur as the grieving person accepts that the loved one is deceased and life will be different.

The nurse is caring for a client who recently found out they have a terminal illness. The nurse notes that the client is hostile and yelling. Which statement by the nurse shows understanding of the Kübler-Ross emotional responses to impending death? "Each stage of dying must be completed prior to moving to the next stage." "Sometimes a person returns to a previous stage." "The duration of all stages is a few hours." "The process is the same from person to person."

"Sometimes a person returns to a previous stage." Explanation: Kübler-Ross (1969) studied the responses to death and dying. The findings are as follows: Sometimes a person returns to a previous stage; the stages of dying may overlap; the duration of any stage may range from as little as a few hours to as long as months; the process varies from person to person.

When preparing for palliative care with the dying client, the nurse should provide the family with which explanation? "Palliative care is the gradual withdrawal of mechanical ventilation from a client with terminal illness and poor prognosis." "In palliative care, no attempts are to be made to resuscitate a client whose breathing or heart stops." "The goal of palliative care is to give clients the best quality of life by the aggressive management of symptoms." "The client will have to go to an inpatient hospice unit in order to receive palliative care."

"The goal of palliative care is to give clients the best quality of life by the aggressive management of symptoms." Explanation: Palliative care involves taking care of the body, mind, spirit, heart, and soul. It views dying as something natural and personal. The goal of palliative care is to give clients with life-threatening illnesses the best quality of life they can have by the aggressive management of symptoms. A do-not-resuscitate order means that no attempts are to be made to resuscitate a client whose breathing or heart stops. Gradual withdrawal of mechanical ventilation from a client with a terminal illness and poor prognosis is called terminal weaning. Clients do not have to be in an inpatient hospice unit to receive palliative care.

"My father has been dead for over a year and my mother still cannot talk about them without crying. Is that normal?" How should the nurse respond? "It is not considered normal. Has your mother considered seeing a therapist about their grief." "The inability to talk about one's spouse without crying, even after a year, is still considered normal." "In fact, the more that someone cries about a loss, the better they are dealing with it." "Did your mother cry a lot before your father died?"

"The inability to talk about one's spouse without crying, even after a year, is still considered normal." Explanation: Normal responses to bereavement after 1 year include the inability to speak of the deceased without intense emotion, clinical signs of depression, and feelings of meaninglessness. Increased crying does not necessarily signal increased coping, however.

When a client with end-stage renal failure states, "I am not ready to die," what is the appropriate nursing response? "Have you talked with your spiritual leader about your fears?" "I'm sure you are angry and sad." "This must be very difficult for you." "Yes, this is a terrible diagnosis you've received."

"This must be very difficult for you." Explanation: The nurse should use statements with broad openings, such as "This must be difficult for you," to allow the client to continue expressing concerns and to acknowledge the client's feelings. This facilitates communication and allows the client to choose the topic or manner of response during this stage of the grieving process. Assuming the client is angry and sad or indicating that this is "a terrible diagnosis" is not an appropriate way to promote coping. The nurse should automatically assume a spiritual leader is desired.

The nurse is providing care to a group of terminally ill clients. The client who is most likely experiencing the anger stage of grief is the one who states: "I don't care about anything. I have no energy." "I do not believe I have this disease." "Why did this have to happen to me?" "I just want to see my son have a family of his own."

"Why did this have to happen to me?" Explanation: The client is expressing anger when displaying a "why me" attitude. The other statements are reflective of other stages of grief.

Which assessment finding would best support a nursing concern of disordered grieving? A client cries frequently and loudly in the weeks following their child's death in an accident. A client has been experiencing chronic insomnia since their parent's death earlier this year. A client blames themself for not doing more to make their spouses's recent death more comfortable. A client is unable to return to work after their sibling's death 18 months ago.

A client is unable to return to work after their sibling's death 18 months ago. Explanation: An inability to return to normal activities 18 months after a sibling's death is suggestive (though not definitive) of disordered grieving. Crying and having difficulties sleeping are not unusual and will often accompany healthy grieving. A feeling of "not doing enough" is common during grief and would only be considered disordered if this became a long-term and all-encompassing belief.

Which priority intervention should the nurse plan to implement to reduce a client's discomfort during terminal weaning? Administer sedation and analgesia. Have the client's family remain at the bedside. Offer emotional support to the family. Provide an explanation of the process.

Administer sedation and analgesia. Explanation: Terminal weaning is the gradual withdrawal of mechanical ventilation from a client with a terminal illness. Providing sedation and analgesia is the best way to reduce the client's discomfort during the process. The nurse participates in the process by educating the client and family about the burdens and benefits of continued ventilation and what to expect when terminal weaning is initiated. Supporting the family and having the family remain at the bedside are important roles of the nurse during terminal weaning, but do not directly affect discomfort as much as sedation and analgesia.

Assisted suicide is expressly prohibited under statutory or common law in the overwhelming majority of states. Yet public support for assisted suicide has resulted in a number of state ballot initiatives. The issue of assisted suicide is opposed by nursing and medical organizations as a violation of the ethical traditions of nursing and medicine. Which scenario would be an example of assisted suicide? Granting a client's request not to initiate enteral feeding when the client is unable to eat Administering a morphine infusion Neglecting to resuscitate a client with a "do not resuscitate" status Administering a lethal dose of medication

Administering a lethal dose of medication Explanation: Assisted suicide refers to providing another person the means to end his or her own life, such as administering a lethal dose of a medication. This is not to be confused with the ethically and legally supported practices of withholding or withdrawing medical treatment in accordance with the wishes of the terminally ill individual. Administering a morphine infusion may be used to assist with a client's pain near the end of life. Granting a client's request not to initiate enteral feeding when the client is unable to eat is an example of wishes of a terminally ill client, and the agreed-upon measures near the end of life. Neglecting to resuscitate a client with a "do not resuscitate" status is following the prescribed, mutually agreed-upon decisions about care

Which statement regarding perceptions of death by children is accurate? Adolescents tend to respond to death and grief better than adults. Preschool-age children view death as a spiritual release. At about age 9, children perceive death as irreversible. Toddlers perceive death as irreversible and unnatural.

At about age 9, children perceive death as irreversible. Explanation: At about 9 years of age, the child's concept of death matures, and the child perceives death realistically as irreversible, universal, inevitable, and natural. In the early school years (not toddler years), the child perceives death as unnatural, reversible, and avoidable. The concept of spiritual release is beyond most preschool-aged children. Adolescents generally have the capacity to mourn fully, but they are at greater risk for poorer outcomes than are adults because of the numerous other stressors and developmental changes they are experiencing during this stage of the life cycle.

A client at a health care facility has died after a prolonged illness. A nurse is assigned to perform postmortem care for the client. Which intervention should the nurse perform when providing postmortem care? Place a rolled towel under the head. Apply hairpins and clips. Avoid replacing dentures in the mouth. Cleanse drainage from the skin.

Cleanse drainage from the skin. Explanation: The nurse should cleanse secretions and drainage from the skin to ensure delivery of a hygienic body. The dentures should be replaced in the mouth, as they maintain the natural contour of the face. A small rolled towel is placed beneath the chin of the client to close the mouth; it is not placed under the head. The nurse should remove all hairpins or clips to prevent accidental trauma to the client's face.

The nurse has noted that a dying client is increasingly withdrawn and is often teary at various times during the day. The nurse recognizes that the client may be experiencing which of Kübler-Ross's stages of grief? Depression Anger Bargaining Denial

Depression Explanation: Depression is a commonly accepted form of grief and it represents the emptiness when the client realizes the person or situation is gone or over. Signs and symptoms may be withdrawn, sadness, crying, and flat affect. Denial is the stage where client may disregard that the news of diagnosis or death is not true. Anger is the stage where the client may think "why me?" and "life's not fair!" Bargaining is the stage of false hope. The client might falsely make themselves believe that they can avoid the grief through a type of negotiation. The stages are denial, anger, bargaining, depression, and acceptance.

The wife of a client who has been diagnosed with a terminal illness asks the nurse about the differences between palliative care and hospice care. Which information would the nurse most likely include in the response? Hospice care focuses on quality of life while palliative care focuses on length of life. Hospice provides physical and psychological support; palliative care provides social and spiritual support. Hospice care is provided for clients who have 6 months or less to live; palliative care is provided at any time during illness. Hospice care differs from palliative care in its foundational philosophy.

Hospice care is provided for clients who have 6 months or less to live; palliative care is provided at any time during illness. Explanation: Hospice programs, which, in effect, are a type of insurance benefit, focus on relieving symptoms and supporting clients with a life expectancy of 6 months or less, and their families. Palliative care, on the other hand, may be given at any time during a client's illness, from diagnosis to end of life. Hospice and palliative care programs provide care that focuses on quality rather than length of life. Both hospice and palliative care share a similar foundation. Hospice and palliative care provide physical, social, psychological, and spiritual support through a team of health care professionals and lay volunteers.

The wife of a man who is dying tells the nurse: "Harold was so good to me. He was like a saint with his patience. I will miss him terribly" Which stage of grief is this woman experiencing, according to Engel? Outcome Awareness Idealization Restitution

Idealization Explanation: Idealization is the exaggeration of the good qualities that the person had, followed by acceptance of the loss and a lessened need to focus on it. Restitution involves the rituals surrounding loss—with death, it includes religious, cultural, or social expressions of mourning, such as funeral services. Developing awareness is characterized by physical and emotional responses such as anger, feeling empty, and crying. Outcome, the final resolution of the grief process, includes dealing with loss as a common life occurrence.

A home hospice client who has Medicare is experiencing extreme pain at home and is refusing to receive inpatient care due to concerns over the cost of inpatient care. What teaching will the nurse include in the plan of care? Worry about payment should not be a concern for the client. Inpatient pain management for hospice clients is covered by Medicare. Medicare does not cover pain control in the home; it must be in the inpatient care. Medicare does not cover costs that are not directly related to the diagnosis.

Inpatient pain management for hospice clients is covered by Medicare. Explanation: Inpatient pain management is covered by Medicare as are any other Medicare-covered services needed to manage pain and other symptoms as recommended by the hospice team. Medicare will cover pain control in the home as well, but for extreme pain, hospitalization may be required. Telling a client not to worry about payment does not educate about what services are available.

A nurse is providing care to a terminally ill client. Which finding would alert the nurse to the fact that the client is dying? Select all that apply. Irregular heart rate Regular deep respirations Strong, bounding pulse Decreased urine output Pale, cool skin

Pale, cool skin Decreased urine output Irregular heart rate Explanation: Signs of dying include extremely pale, cyanotic, jaundiced, mottled or cool skin; irregular heart rate; weak, rapid, irregular pulse; shallow, labored, faster, slower, or irregular respirations; and decreased urine output.

When assessing a person who is grieving using the grief cycle model, which concept would be most important for the nurse to keep in mind? Select all that apply. Stages occur at varying rates among people. Some people actually skip some stages of grief altogether. The stages of grief occur linearly and are static. The stages are relatively discrete and identifiable. People vary widely in their responses to loss.

People vary widely in their responses to loss. Stages occur at varying rates among people. Some people actually skip some stages of grief altogether. Explanation: In reality, the stages of the grief cycle model are not as discrete as the model indicates. However, it is helpful to use the model as a general guide, while keeping in mind that people may vary greatly in their responses to loss and still fall within the normal response range. Grieving persons may go through the stages at varying rates, go back and forth between stages, or skip stages.

The nurse is assisting a client and family with the death and dying process. In an effort to provide culturally competent care, what action will the nurse perform first? Create a referral to spiritual care. Seek to understand the client's beliefs. Explain the stages of grief. Ensure the family has sufficient privacy to grieve.

Seek to understand the client's beliefs. Explanation: Nurses should gain knowledge of the specific cultural and religious beliefs of the client and the family. Understanding the beliefs of the client can lead nurses to provide culturally competent care. Explaining the stages of grief to a family does not provide culturally competent care, as all religions and beliefs may grieve in different ways. Leaving the family to grieve alone may not be culturally competent, as the nurse needs to understand the beliefs of the family first. Spiritual care may or may not be appropriate, depending on the family's specific beliefs and needs.

A nurse at the health care facility cares for several clients. Some of the clients may require end-of-life care. Which case may require the service of a coroner? The client was diagnosed with acute kidney failure. The client was being administered oxygen therapy. The client did not have any recent medical consultation. The client is an older adult with a history of hypertension

The client did not have any recent medical consultation. Explanation: The services of a coroner may be needed in a case where the client did not have any recent medical consultation. A coroner is a person legally designated to investigate deaths that may not be the result of natural causes. Death following a diagnosis of acute kidney injury, administration of oxygen therapy, or a history of hypertension does not call for the services of a coroner.

A client in a long-term care facility has signed a form stating that he does not want to be resuscitated. He develops an upper respiratory infection that progresses to pneumonia. His health rapidly deteriorates, and he is no longer competent. The client's family states that they want everything possible done for the client. What should happen in this case? The wishes of his family should be followed. The client should be resuscitated if he experiences respiratory arrest. The client should be treated with antibiotics for pneumonia. Pharmacologic interventions should not be initiated.

The client should be treated with antibiotics for pneumonia. Explanation: The client has signed a document indicating a wish not to be resuscitated. Treating the pneumonia with antibiotics is not a resuscitation measure. The other options do not respect the client's right to choice.

A client severely injured in a motor vehicle accident is rushed to the health care facility with severe head injuries and profuse loss of blood. Which sign indicates approaching death? The client is calm and peaceful. The frequency of urination decreases. The client's breathing becomes noisy. The arms and legs are warm to touch.

The client's breathing becomes noisy. Explanation: Noisy breathing, or death rattle, is common during the final stages of dying because of the accumulation of secretions in the lungs. Reduced urination is not seen during the final stages of dying. Instead, the client develops loss of control over bladder and bowels due to loss of neurological control. The peripheral parts of the client's body such as the arms and the legs are cold to touch (not warm) because the circulation is directed away from the periphery and toward the core of the body. Clients in the last stages of dying are usually not calm and peaceful; they occasionally exhibit sudden restlessness due to hunger for oxygen.

What is a proper action to take when preparing a child for death? Select all that apply. Expect the child to alternate between grieving and normal functioning. Praise stoicism. Encourage remembrance of deceased. The nurse should know her own feelings and beliefs. Compare the child to the deceased.

The nurse should know her own feelings and beliefs. Encourage remembrance of deceased. Expect the child to alternate between grieving and normal functioning. xplanation: When preparing a child for death, it is important for the nurse to know her own feelings and beliefs; to be honest; begin at the child's level; include the child in family rituals related to death and mourning; encourage expression of feelings; provide security and stability; encourage remembrance of the deceased; recognize that children grieve differently than adults; expect the child to alternate between grieving and normal functioning; talk openly about death and the feelings it generates; and introduce death concepts into conversations naturally.

Which are signs of a "good death"? Select all that apply. The person dies with dignity. The person has a sense of completion of life. The person dies according to the wishes of the family. The person experiences moderate pain. The person is prepared for death.

The person dies with dignity. The person is prepared for death. The person has a sense of completion of life. Explanation: A good death is one that allows a person to die on their own terms, relatively free of pain, and with dignity. It is free from avoidable distress and suffering for clients, families, and caregivers; in general accord with clients' families wishes; and reasonably consistent with clinical, cultural, and ethical standards (Institute of Medicine, 1997). The definition of a good death varies for each client, but there are factors important for a good death, including control of symptoms, preparation for death, opportunity to have a sense of completion of one's life, and a good relationship with health care professionals.

The husband of a client who has died cannot express his feelings of loss and at times denies them. His bereavement has extended over a lengthy period. What type of grief is the husband experiencing? Inhibited grief Anticipatory grief Normal grief Unresolved grief

Unresolved grief Explanation: In unresolved grief, a person may have trouble expressing feelings of loss, may deny them, and the bereavement may extend over a lengthy period. Anticipatory loss or grief occurs when a person displays loss and grief behaviors for a loss that has yet to take place. Inhibited grief occurs when a person suppresses feelings of grief and may instead manifest somatic (body) symptoms, such as abdominal pain or heart palpitations. Normal expressions of grief may be physical (crying, headaches, difficulty sleeping, fatigue), emotional (feelings of sadness and yearning), social (feeling detached from others and isolating oneself from social contact), and spiritual (questioning the reason for the loss, the purpose of pain and suffering, the purpose of life, and the meaning of death).

The husband of a client who has died cannot express his feelings of loss and at times denies them. His bereavement has extended over a lengthy period. What type of grief is the husband experiencing? Unresolved grief Inhibited grief Normal grief Anticipatory grief

Unresolved grief Explanation: In unresolved grief, a person may have trouble expressing feelings of loss, may deny them, and the bereavement may extend over a lengthy period. Anticipatory loss or grief occurs when a person displays loss and grief behaviors for a loss that has yet to take place. Inhibited grief occurs when a person suppresses feelings of grief and may instead manifest somatic (body) symptoms, such as abdominal pain or heart palpitations. Normal expressions of grief may be physical (crying, headaches, difficulty sleeping, fatigue), emotional (feelings of sadness and yearning), social (feeling detached from others and isolating oneself from social contact), and spiritual (questioning the reason for the loss, the purpose of pain and suffering, the purpose of life, and the meaning of death).

The hospice nurse is caring for a client with lung cancer. The client's adult child states, "The client is not happy with anything I do for them. It is not like the client to be so hypercritical." The nurse understands that the client is likely in which stage of grief according to Kübler-Ross? denial bargaining depression anger

anger Explanation: Kübler-Ross proposed five stages of grief: (a) denial, (b) anger, (c) bargaining, (d) depression, and (e) acceptance. Denial may range from complete denial of the illness and impending death to denial of the effect that dying will have on self and others. In the second stage, anger may be directed toward fate, a higher power, family members, health care providers, or others. Bargaining occurs as the client seeks to delay the dreaded event; the client bargains with a higher power for more time and, in return, promises to do something to repay the higher power for this favor. Depression occurs when the client acknowledges the reality and inevitability of the impending death. In the final stage, acceptance, the client comes to terms with the loss, begins to detach from supportive people, and loses interest in worldly activities.

The spouse of a recently deceased client states, "I just cannot believe the client left me. The client swore they would never leave me and I feel betrayed!" Within the Kübler-Ross stages of grief, what stage does the nurse identify the spouse is experiencing? anger denial and isolation acceptance bargaining

anger Explanation: The spouse is identified as being in the anger stage of the grieving process. The spouse has accepted the fact that the client is gone but is angry and betrayed at the departure from life. The spouse has yet to accept this death and may have some overlapping with depression as well. There is no evidence of bargaining or denial.

The nurse is caring for a client who is dying. The nurse overhears the client saying, "God, if you will only let me live to see my daughter get married, I promise I will start going to church again." The nurse understands that the client is in which stage of grief according to Kübler-Ross? depression acceptance denial bargaining

bargaining Explanation: Kübler-Ross proposed five stages of grief: (a) denial, (b) anger, (c) bargaining, (d) depression, and (e) acceptance. Denial may range from complete denial of the illness and impending death to denial of the effect that dying will have on self and others. In the second stage, anger may be directed toward fate, God, family members, health care providers, or others. Bargaining occurs as the client seeks to delay the dreaded event; the client bargains with God for more time and, in return, promises to do something to repay God for this favor. Depression occurs when the client acknowledges the reality and inevitability of the impending death. In the final stage, acceptance, the client comes to terms with the loss, begins to detach from supportive people, and loses interest in worldly activities.

Upon admission, the nurse should give priority to addressing which need of a client who is displaying symptoms of dysfunctional grief? self-care activities coping strategies spiritual distress pain management

coping strategies Explanation: Dysfunctional grief can be unresolved or inhibited. In unresolved grief, a person may have trouble expressing feelings of loss or may deny them. Unresolved grief also describes a state of bereavement that extends over a lengthy period. With inhibited grief, a person suppresses feelings of grief and may instead manifest somatic (body) symptoms. Coping strategies are necessary in the grieving process and for resolution of grief. Many times individuals experiencing dysfunctional grief have difficulty with self-care activities; however, the individual should be encouraged to perform these activities independently. Pain management is usually not necessary in the management of dysfunctional grief. The spiritual needs of the client are important as well and should be considered after coping strategies have been addressed.

A client is informed about the results of a biopsy, which indicate a malignant tumor that has spread. The client states, "Well once you remove the tumor, I will be just fine." What stage of the grief process does the nurse identify the client is experiencing? denial acceptance anger bargaining

denial Explanation: By making this statement, the client denies the seriousness of the malignant tumor diagnosis. Denial is often the first emotion the client will experience, as initially it helps in coping with the reality of impending death. There is nothing in the client's statement to indicate anger or acceptance. Bargaining would be indicated by the client negotiating with a higher power to extend life or delay the inevitable.

The nurse is taking care of a client recently involved in a motor vehicle accident during which a pet was thrown from the vehicle and died. The client states, "My heart aches and I can't eat or sleep." According to Kübler-Ross, what stage of grief is the client experiencing? acceptance denial and isolation depression bargaining

depression Explanation: According to Kübler-Ross (1969), the client would be in the depression stage, as evidenced by the loss of sleep and appetite. The other stages do not apply to this client according to the statements made.

The children of a client with late-stage Alzheimer disease have informed the nurse on the unit that their parent possesses a living will. The nurse should recognize that this document is most likely to: give permission for organ donation. dictate how the client wants their estate handled after their death, and by whom. make legal provisions for active euthanasia. specify the treatment measures that the client wants and does not want.

specify the treatment measures that the client wants and does not want. Explanation: Living wills provide instructions about the kinds of health care that should be used or rejected under specific circumstances. The management of an individual's estate is specified in a will, not a living will. It is not legal for a living will to make provisions for active euthanasia. A living will may or may not include reference to organ donation, but normally this is addressed in a separate, specific consent card or document.

The nurse is giving palliative care to a client with a diagnosis of COPD. What is the goal of palliative care? to improve the client's and family's quality of life to support aggressive treatment for cure to provide physical support for the client The client may develop a separate plan with each discipline of the health care team.

to improve the client's and family's quality of life Explanation: The goal of palliative care is to improve the client's and the family's quality of life. The support should include the client's physical, emotional, and spiritual well-being. Each discipline should contribute to a single care plan that addresses the needs of the client and family. The goal of palliative care is not aggressive support for curing the client. Providing physical support for the client is also not the goal of palliative care. A separate plan of care developed by the client with each discipline of the health care team is not the goal of palliative care.


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