Ch 3 Med Surg
During a home care visit to a client in hospice, the client's spouse reveals to the nurse an understanding that the client's death is inevitable. Recognizing the spouse is exemplifying the Kübler-Ross stage of acceptance, which statement by the nurse is most appropriate?
"Tell me how you plan to react when you first realize that your spouse is breathless and has no pulse."
A terminally ill patient is admitted to the hospital. The patient grabs the nurse's hand and asks, "Am I dying?" What response would be best for the nurse to give?
"Tell me more about what's on your mind."
A client is diagnosed with type 2 diabetes mellitus. The client takes metformin and exenatide and reports adhering to a diet. The glycohemoglobin is 5.9%. According to the stable phase of the Trajectory Model of Chronic Illness, how should the nurse respond?
Acknowledges that the client is performing satisfactorily
The client who has the chronic condition of diabetes, reports blurry vision, and admits to nonadherence to the diet and medications. The home health nurse checks the client's fasting blood glucose level, which is 412 mg/dL. What phase of the Trajectory Model of Chronic Illness does the nurse assess this client is in?
Acute
A 90-year-old home care client's son has been designated to make decisions regarding the client's medical care when the client is no longer able to do so. As the client nears the end of life, the son is consulted on an ever-increasing basis. What legal instrument activates the son's decision-making designation?
durable power of attorney for health care
A nursing instructor is discussing the causes of the increasing number of people with chronic conditions. Which of the following would the nurse correctly identify as a cause?
Early detection and treatment of diseases
Which is a cause related to the increasing number of people with chronic conditions?
Improved screening and diagnostic procedures
The family of a dying client being cared for at home is requesting information on how best to prepare food. Which suggestion by the nurse may stimulate appetite?
Preparing cool or cold foods that may be better tolerated
Which cardiovascular findings indicate to the nurse that the condition of the dying client is worsening?
Pulse 104 beats/minute in the morning, 62 beats/minute in the afternoon with mottled feet and ankles
The hospice nurse understands that many factors directly or indirectly affect how a person dies. Which of the following is a changeable factor that can be influenced by the nurse when dealing with the dying patient?
Relationship with the health care providers
A client has been declared to have a terminal illness. What intervention will a nurse perform regarding the final decision of a dying client?
Respect the client's and family members' choices
The client has been diagnosed with terminal COPD. The client and the client's family have not yet agreed on the final arrangements and are discussing options. How can the nurse best intervene in these final decisions?
Respect the client's autonomy and right to determine how to spend the rest of his or her life
The nurse is caring for a pediatric client who is dying. The best way to provide care and comfort to dying clients and their families is to first do which of the following?
Explore own feelings on mortality and death and dying.
A patient's family member asks the nurse what the purpose of hospice is. What is the best response by the nurse?
It will enable the patient to remain home if that is what is desired."
A client has lost mobility following a stroke. The nurse has established interventions that include providing direct care to the client, teaching, making referrals, and managing the case, to meet the goal. The next step is to
Plan with the client how to incorporate the regimen into the client's activities of daily living.
In spite of administering the prescribed pain medication, a dying client is still experiencing dyspnea due to fear and anxiety. Which nursing intervention should the nurse use to potentiate the effects of pain medication and help reduce the dyspnea?
Use imagery, humor, and progressive relaxation
