PrepU Topic 16: Family Caregiving and End of Life Care
During a home visit the nurse suspects that an older client is having increasing difficulty with memory. What should the nurse encourage the family members to do at this time? A. Attend a support group meeting B. Place locks on cabinets and remove stove knobs C. Place the client in a skilled facility D. Hire full time help
A. Attend a support group meeting For the client with a memory problem, the family should be informed of support and self-help groups that can assist them, such as Alzheimer's Disease and Related Disorders Association. There is not enough information to determine if full-time help is required at this time. A skilled facility may be required later but at this time, it is not a priority. Locking the cabinets and removing stove knobs might be required at a later time however these interventions may be premature.
A middle-aged son grocery shops and transports an older parent to health care appointments instead of attending a son's soccer game. Which generation would the son most closely identify? A. Nuclear B. Sandwich C. Skipped D. Single-parent
B. Sandwich A person in the sandwich generation is a middle-aged person who cares for children and parents. A skipped-generation household is a household in which a grandparent is raising minor grandchild with no parent present. Nuclear and single-parent are types of family structures.
When explaining family member roles in the care of older adults, what characteristic of a family member most clearly suggests that he or she plays a deviant role? A. Not involved in daily activities B. Strayed from family norms C. Not geographically close D. Consulted for problem solving
B. Strayed from family norms Strayed from family norms is on the list as a family member deviant role. Not geographically close, not involved in daily activities, and consulted for problem solving are on the list of caregiver family roles.
Which important questions would the nurse ask the older client to assess attitudes, values, and beliefs? A. Do you feel that the younger should take care of the old or that children owe their parents nothing? B. Do you love your son and do you think he's turned out the way that you had hoped? C. Do you admire your brother? D. Do you think that you'll have enough money to continue your lifestyle as long as you'd like?
A. Do you feel that the younger should take care of the old or that children owe their parents nothing? Do you feel that the younger should take care of the old or that children owe their parents nothing is an important question to assess attitudes, values, and beliefs of the older client. Do you like your son, do love your granddaughter, and do you admire your brother assesses how the family feels about each other.
The nurse notes that an older client is to begin receiving hospice care. What should the client and family expect when receiving this care? Select all that apply. A. Caregiver support B. Family support C. Client support D. Palliative care E. Curative treatment
A, B, C, D Hospice care is a program that delivers palliative care to dying individual and support to dying person and that person's family and caregivers. Curative treatment is not a part of palliative or hospice care.
Which of the following stages may the dying client experience? Select all the apply. A. Acceptance B. Repression C. Bargaining D. Denial E. Anger
A, C, D, E Denial, anger, bargaining, and acceptance are identified stages. Repression is not a stage in the dying process.
An older adult client had a severe stroke several days ago. The nurse enters the client's room to find the spouse softly crying at the bedside, making no attempt to acknowledge the nurse's presence. Which therapeutic response by the nurse is appropriate? A. "I am here; should I leave you alone for now?" B. "Did you feel like you were able to discuss the client's treatment options thoroughly?" C. "Do you feel like your spouse was able to live a full life?" D. "What is it that makes you the saddest about your spouse's situation?"
A. "I am here; should I leave you alone for now?" In light of the fact that the spouse is grieving quietly and has not acknowledged the nurse's presence, it is appropriate to offer to leave the spouse alone. Alluding to treatment options, a "full life," or particularly sad aspects of the situation is inappropriate.
An adult daughter with a physical disability plans to quit her job to take care of her ailing parents. What should the nurse say in response to the daughter's plan? A. "Will you physically be able to do all of this care?" B. "These are the best years of your parents' lives and they should be shared." C. "You are so fortunate to have both of your parents at this age." D. "Your parents will be so happy to hear this."
A. "Will you physically be able to do all of this care?" The nurse should guide the family to view the situation realistically. Perhaps a leave of absence rather than resignation from a job is warranted to assist a parent or spouse through convalescence. Perhaps the daughter's disability interferes with the ability to care for the clients adequately. Often, an objective outsider can guide the family in viewing the real situation and understanding the extent of care needs. The other statements disregard the daughter's plan and physical limitations. The daughter's plan is unrealistic.
What activity demonstrates a nurse's understanding of effective care for the dying client and the family? A. Asking about needs and how the nurse can help meet them. B. Encouraging both client and family to attend a death and dying support group C. Providing them with an opportunity to discuss feelings and fears associated with dying D. Arranging for a spiritual consult with the chaplain
A. Asking about needs and how the nurse can help meet them. Because the dying process is unique for every human being, individualized nursing intervention is required. Asking the family and the dying client what "they need" addresses the issues and provides individualized care. While the other options may prove helpful, they do not address the issue of individualized care.
An Advance directive protects an older dying client's rights under which important law? A. The Patient Self Determination Act (PSDA) B. The Health Information Technology for Economic and Clinical C. Health Act (HITECH) D. The Health Insurance Portability and Accountability Act (HIPAA) E. The American Recovery and Reinvestment Act (ARRA)
A. The Patient Self Determination Act (PSDA) The Patient Self Determination Act (PSDA) protects an older dying client's rights. The Health Insurance Portability and Accountability Act (HIPAA) protects client privacy. The American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health Act (HITECH) includes information on health technology mandates.
The nurse is caring for several clients that request hospice services. Which client(s) will the nurse refer for hospice services that meet the criteria? SAPA A. client who is informed that they have less than 6 months to live from amyotrophic lateral sclerosis B. older adult client who had a myocardial infarction and is taking anticoagulants and a beta blocker C. client with stage IV pancreatic cancer that prefers to stay at home to die and has a physician's referral D. client who was just diagnosed with chronic obstructive pulmonary disease and started on steroids and bronchodilators E. client who was involved in a motor vehicle accident and is paralyzed from the waist down due to a spinal cord injury
A. client who is informed that they have less than 6 months to live from amyotrophic lateral sclerosis C. client with stage IV pancreatic cancer that prefers to stay at home to die and has a physician's referral The clients that meet the criteria to obtain hospice services are: the client that has less than 6 months to live with amyotrophic lateral sclerosis and the client with cancer that has a physician's referral. These are the 2 criteria in order to qualify for care. The client newly diagnosed with chronic obstructive pulmonary disease is not at the stage that requires hospice care. It could take many years for the disease to progress if care is consistent and the client is adherent to treatment. Paralysis and more extensive care is not a criteria for hospice, and there are other services that the client may be able to use such as home health, rehabilitation, or personal care. A myocardial infarction for an older adult taking medications is not a criteria for hospice services, because there is no indication that the client has less than 6 months to live or a physician's referral.
An older client with a terminal illness who has been depressed for several weeks admits to having a supply of pain medication intended to be used to commit suicide. What should the nurse do? A. report the conversation to the provider and suggest suicide precautions B. ask that the client tell the nurse when the plan will be implemented C. search the client's belongings for the pills when the client is asleep D. recommend that the client perform the act when not hospitalized
A. report the conversation to the provider and suggest suicide precautions If there are signs of depression, promptly alert the medical provider and discuss the need for suicide precautions. Just because a person is near the end of life does not mean that suicide is the best decision. The nurse should not encourage the client to perform the act. Searching the client's belongings is a violation of privacy. Asking the client to inform the nurse when the action will take place encourages the client to perform the action and could mean that the nurse assisted with the client's suicide.
An adult daughter is concerned about an aging parent who lives in the home alone. What should the nurse suggest the daughter discuss during the next telephone call with the client? Select all that apply A. Favorite television show B. Last food eaten C. Usual time up in the morning D. Last purchase of groceries E. Usual bedtime
B, C, D, E Nurses should advise long-distance caregivers about what issues they should review during telephone calls with their relative that can aid in identifying needs, risks, and changes in status. These can include questions as to when groceries were last purchased, what time the person goes to sleep and awakens, food consumption, status of prescriptions, contact with others, and new symptoms. The favorite television show would not provide useful information to the daughter regarding the aging parent's needs.
The family of a 69-year-old brought the client for an appointment. The client, who uses a wheelchair, is alert and oriented but is more quiet and reluctant to answer questions regarding obvious weight loss, compared to the last visit. What action should the nurse take initially to best address the client's health needs and safety? A. Assure the client is safe from retaliation. B. Use the Elder Mistreatments Assessment tool. C. Offer the family and client counselling. D. Encourage client to learn healthy eating.
B. Use the Elder Mistreatments Assessment tool. The nurse should first use the Elder Mistreatments Assessment tool. The nurse does not have enough information to do any type of intervention. The other options are interventions, which will be performed, as needed, after assessment is performed.
An older client who lives alone is being discharged after joint replacement surgery. What question should the nurse ask to determine this client's family support system? A. "Who drives you to the bank?" B. "Who do you call for emotional support?" C. "Who does your laundry?" D. "Who cleans your apartment?"
B. "Who do you call for emotional support?" Asking an older adult "Who do you call for emotional support?" facilitates the identification of significant persons who perform family functions for them. The older adult may pay for someone to help with laundry, cleaning, and transportation.
An older adult client at the end of life states to the nurse, "I do not want to take any additional chemotherapy. I would rather die comfortably than take any more medication that makes me so sick." Which response by the nurse demonstrates the ethical principle of autonomy? A. "You have to know that by stopping the chemotherapy, your cancer will spread very quickly. What will your family feel about it?" B. "You are able to make decisions related to your health care and we will relay this information so that the chemotherapy will be stopped." C. "Your primary care provider wants you to continue the chemotherapy and you know that the provider is only looking out for your best options." D. "Right now you are feeling defeated and sick. Once you feel better, I am sure you will change the decision to stop chemotherapy."
B. "You are able to make decisions related to your health care and we will relay this information so that the chemotherapy will be stopped." The principle of autonomy is to allow the client to make decisions regarding their own health care. Attempting to belittle the client's decision or imply that the client should feel guilty for choosing not to take chemotherapy any longer by discussing the affect on the client's family is not therapeutic. Informing the client that the primary care provider should be the one making the decisions is considered "paternalism."
Which of the following is the most complete information for a nurse to include during a presentation on elder care? A. Government services no longer provide care for older adults B. Greater numbers of families are providing more complex care for older adults for longer periods of time. C. Greater numbers of families are providing more complex care for older adults. D. Fewer families are providing care for older adults
B. Greater numbers of families are providing more complex care for older adults for longer periods of time. Greater numbers of families are providing more, not less, complex care for older adults for longer, not shorter, periods of time. Government is still involved in various ways.
A nurse manager of an intensive care unit develops plans to improve end-of-life care for clients in the unit. Which action is the priority? A. Increase communication between professionals about end-of-life decision making. B. Guide staff to improve communication with families about end-of-life decision making. C. Survey clients and families about their end-of-life needs. D. Create a script for nurses to use when discussing hospice and palliative care.
B. Guide staff to improve communication with families about end-of-life decision making. In recent years, nurses and other health care professionals raised concerns about the need to improve end-of-life care in hospitals. Much of this concern is associated with poor communication between professionals and families about end-of-life decision making. Creating a script can help with that specific need, but the clients continue to experience pain, indignity, social isolation, and uncomfortable symptoms related to ineffective and unwanted life-sustaining treatments, particularly in intensive care units. Interprofessional communication will also help; the priority is between staff and families.
Which end-of-life nursing diagnosis is associated with the aging client and emaciation? A. Noncompliance B. Impaired skin integrity C. Disturbed thought process D. Deficit, knowledge
B. Impaired skin integrity Impaired skin integrity is the nursing diagnosis associated with the aging client and emaciation. Deficit, knowledge is associated with diagnostic tests, treatments, drugs, and pain management. Disturbed thought process is associated with depression, anxiety, fear, and isolation.
A client receiving end-of-life care is experiencing severe constipation. What should the nurse request from the health care provider to help this client? A. Enema B. Laxative C. Antiemetic D. Stool softener
B. Laxative Knowing that the risk of constipation is high, nursing staff should take measures to promote regular bowel elimination in terminally ill clients. Laxatives usually are administered on a regular schedule. An enema would be uncomfortable for this client. There is no evidence that the client needs an antiemetic. A stool softener may be appropriate one the bowel pattern has been reestablished with the use of laxatives.
The nurse overhears an older client say to an adult son "you can never get married while I'm alive because I need you more than anyone." What should the nurse suspect is occurring within this family? A. son enjoys spending time with the client B. client has limited financial resources C. client manipulating the son D. overdependence of the son on the client
C. client manipulating the son Family dysfunction includes an older parent's domination and manipulation of an adult child. There is no evidence to suggest that the client has limited resources, the son is overly dependent on the client, or the son enjoys spending time with the client.
A Greek Orthodox priest arrives to visit a client with a terminal illness. What should the nurse expect the client to receive from this clergy member? A. baptism B. string tied at the wrist C. last rites D. confession
C. last rites For the client who follows the Greek Orthodox faith, beliefs and practices related to death include prayer, communion, and last rites by a priest. Members of The Church of Jesus Christ of Latter-day Saints and Seventh Day Adventists perform baptism as an end-of-life practice. Tying a string around the wrist is a Hindu practice performed at end of life.
An adult daughter is upset that an older client refuses to accept the diagnosis of a terminal illness. What should the nurse explain to the daughter? A. "It means that the client is going to die very soon." B. "It motivates people to stay alive as long as possible." C. "Denying the inevitable helps absorb the shock of the news." D. "It is an indication that the disease has affected the client's brain function."
C. "Denying the inevitable helps absorb the shock of the news." Denial serves several useful purposes for the dying person. It is a shock absorber after learning the difficult news that one has a terminal condition, it provides an opportunity for people to test the certainty of this information, and it allows people time to internalize the information and mobilize their defenses. Denial does not mean that the client is going to die soon or serves as a motivator for the person to stay alive as long as possible. Denial does not indicate that the client's brain is malfunctioning.
What response should the nurse provide when the spouse of a client in the final stage of the dying process asks, "How will I know when death is imminent?" "Try to remember to take care of your needs first." "All you have to do is sit with your spouse and be fully present." "It can vary, but I will explain some of the more common signs to you." "Everyone's experience of death is different, so there is little way of predicting."
C. "It can vary, but I will explain some of the more common signs to you." The nurse should address the question candidly but empathically. Death experiences vary widely, but there are known commonalities. The nurse should avoid deflecting the question.
A nurse in an intensive care unit prepares to perform postmortem care on an older adult client who practices Judaism. Family members are at the client's bedside. Which action by the nurse is appropriate? A. Wash the client's body immediately after death. B. Notify the funeral home to come and transport the client. C. Allow the family to remain with the client. D. Liaise with the hospital chaplain to visit the family in the chapel.
C. Allow the family to remain with the client. For members of the Jewish faith, the dying person should not be left alone. In addition, the nurse will ask the closest relative specifically about postmortem practices. The other noted interventions are not particular to the practice of Judaism, and do not relate to the death rituals that are to be performed.
Which end-of-life nursing diagnosis is associated with the aging client and anxiety? A. Deficit, knowledge B. Impaired skin integrity C. Disturbed thought process D. Disturbed body image
C. Disturbed thought process Disturbed thought process is the nursing diagnosis associated with the aging client and anxiety. Disturbed body image is associated with loss of body function or part, institutionalization, and pain. Impaired skin integrity is associated with immobility, infections, edema, dehydration, and emaciation, and deficit, knowledge is associated with diagnostic tests, treatments, drugs, and pain management.
Which end-of-life nursing diagnosis is associated with the aging client and fear? A. Impaired skin integrity B. Deficient knowledge C. Disturbed thought process D. Disturbed body image
C. Disturbed thought process Disturbed thought process is the nursing diagnosis associated with the aging client and fear. Disturbed body image is associated with loss of body function or part, institutionalization, and pain. Impaired skin integrity is associated with immobility, infections, edema, dehydration, and emaciation, and deficit, knowledge is associated with diagnostic tests, treatments, drugs, and pain management.
A nurse on a geriatric medical care unit consults hospice for current clients. Which nursing intervention will the nurse anticipate after the clients begin hospice care? A. infusing total parenteral nutrition to the client with dysphagia B. assessing the deep tendon reflexes of the client with neurologic impairment C. providing an opioid analgesic to the client with bone metastases D. administering chemotherapy to the client with a diagnosis of pancreatic cancer
C. providing an opioid analgesic to the client with bone metastases The focus of hospice care is on the relief of suffering rather than cure of disease. Relief of suffering often encompasses providing pain relief to clients. Active curative treatments, such as chemotherapy, and parenteral feeding often are forgone. Health assessments that do not assess the client's comfort, such as the assessment of deep tendon reflexes, are not the priority of palliative/hospice care.
The children and spouse of a client dying of renal failure are eager to interact with the client as much as possible in the days before death. Consequently, the client's daughter has questioned the nurse's decision to administer the client's scheduled opioid analgesic stating that the client does not appear to be in pain at the present time and that the drug tends to make the client drowsy. Which should be the nurse's initial response? A. Withhold the analgesic and report the interaction to the health care provider. B. Document the family's reservations, giving the drug after the family leaves. C. Explain the rationale for preventative pain control to the family. D. Administer another analgesic that is less likely to have a sedative effect.
C. Explain the rationale for preventative pain control to the family. Concern regarding the degree of pain that will be experienced, and its management may be a considerable source of distress for dying individuals. The nurse can reduce distress for clients by supplying them with realistic information regarding pain. For the dying client, the goal of pain management is to prevent pain from developing rather than treat it once it occurs. The same holds true for family. An explanation of the principle of preventative pain control may help the family be more at ease with the nurse's administration of the drug and this should constitute the nurse's initial response. If the family remains resistant after an explanation, then the nurse would need to decide about which option would be most appropriate, contact the health care provider or give the medication. Withholding the analgesic without the approval of the health care provider would not be appropriate.
An older client tells the nurse to send family home because an adult daughter keeps complaining about wasting time sitting in a hospital room. On which family dynamic is the client having an issue? A. Attitude, values, and beliefs B. Community ties C. Feelings about family members D. Communication pattern
C. Feelings about family members The dynamics among family members can have positive or negative effects on older individuals. The daughter's complaint about wasting time sitting in a hospital room demonstrates an issue with how the family members feel about each other. There is no evidence that the client is expressing an issue with community ties, communication, or attitudes, values, and beliefs.
The nurse is concerned that an older client's personal care needs will not be met at home. Which family characteristic caused the nurse to have this concern? A. Son handles the client's finances B. Daughter cleans the house and prepares meals C. Former daughter-in-law was the primary caregiver D. Neighbor transports the client to appointments
C. Former daughter-in-law was the primary caregiver A person who was the primary caregiver who is no longer present would cause the nurse to be concerned about the client's care in the home. A son is handling the finances. A daughter is cleaning the house and preparing meals. A neighbor is handling transportation. No one is identified as helping the client meet basic personal care needs.
Which end-of-life nursing diagnosis can be often associated with the aging client and infections? A. Deficient knowledge B. Disturbed thought process C. Impaired skin integrity D. Disturbed body image
C. Impaired skin integrity Impaired skin integrity is the nursing diagnosis associated with the aging client and infections. Disturbed body image is associated with loss of body function or part, institutionalization, and pain. Deficit, knowledge is associated with diagnostic tests, treatments, drugs, and pain management. Disturbed thought process is associated with depression, anxiety, fear, and isolation.
A quality control nurse for a large group of long-term care facilities assesses the quality of care at the end of life for the residents. Which measure(s) indicates quality care? Select all that apply. A. Increase in the number of deaths in the hospital. B. Increase in the number of residents who refuse treatments at the end of life. C. Increase in the use of hospice services. D. Increase in the number of staff trained in palliative care. E. Increase in the percent of residents with advanced dementia.
C. Increase in the use of hospice services. D. Increase in the number of staff trained in palliative care. Studies confirm the need for staff education related to symptom management and other aspects of palliative care. Two measures of quality care at the end of life for nursing home residents are use of hospice services and avoidance of death in the hospital. Neither an increase in residents refusing end-of-life care nor residents with advanced dementia are measures of quality of the care received.
What behavior demonstrates to the nurse that the significant other of a client with a terminal illness has come to accept the certainty of the client's death? A. Providing the client with religious readings B. Asking that a chaplain is available when visiting C. Sharing stories of happy times together D. Holding hands during visits
C. Sharing stories of happy times together the nurse is caring for an older client who is at the end of life and who is in the anger stage. When working with the client's family, the nurse should assess for what responses by family members? Select all that apply.
An adult daughter of an older client with severe health issues is observed sitting in the waiting room crying softly and occasionally closing the eyes. What should the nurse suspect is occurring with this daughter? A. Concern about the amount time waiting B. Discomfort sitting in the chair C. Stress D. Personal health problem
C. Stress Caregiver burden is defined as stresses, challenges, and negative consequences associated with providing assistance to a person in need. Since the daughter is caring for an older client with severe health issues, it is unlikely that the daughter's behavior is because of discomfort from sitting in the chair or time spent waiting. There is not enough information to determine if the adult daughter has personal health problems causing this reaction.
What intervention demonstrates attention to a fundamental right of all individuals facing death? A. Difficult discussions are avoided in the client's presence. B. Physical care is minimal in order to preserve physical strength. C. When death is imminent, a staff member stays with a client who is dying. D. Decisions concerning after-death arrangements are directed to family.
C. When death is imminent, a staff member stays with a client who is dying. The Dying Person's Bill of Rights states, "I have the right not to die alone." The remaining options do not support the individual rights afforded a dying individual.
During a home visit the adult daughter of an older client telephones to find out how the client is recovering after surgery. What should the nurse expect to occur regarding the caregiving relationship between the daughter and client? A. the daughter will immediately move in with the client B. the daughter will continue to phone the client C. the daughter will increase contact with the client D. the client will need less telephone calls over time
C. the daughter will increase contact with the client The provision of family assistance is a subtle, gradual process. What might start as telephone calls may increase to more frequent visits. It is unlikely that the amount of telephone contact will remain the same. The client is not likely to need less telephone contact. It is unlikely that the daughter will immediately move in with the client although this might need to occur, over time.
When explaining family member roles in the care of older adults, which of the following is on the list as a family member victim role? A. The problem child B. The deviant C. The family scapegoat D. An economically abused family member
D. An economically abused family member An economically abused family member is on the list of a family member victim role. The problem child, the family scape goat, and the deviant are on the list of deviant family member roles.
An unemployed adult son lives with an older client who provides the meals and spending money for the son. Which role best describes the son in this family situation? A. Deviant B. Victim C. Decision-maker D. Dependent
D. Dependent A dependent is an individual who relies on the other members of the family for economic or caregiving assistance. A victim is a person who forfeits his or her legitimate rights and may be physically, emotionally, socially, or economically abused by the family. A deviant is the "problem child" or nonconformist who has strayed from family norms; may be the family scapegoat or may provide a sense of purpose for family members who "rescue" or compensate for this individual. The decision-maker is the person who is granted or assumes responsibility for making important decisions or is called on in times of crisis.
The hospital's nursing staff becomes very attached to an older adult client. When the client dies, the nurse on duty hugs family members and cries with them. Which statement best describes the nurse's behavior? A. It would be appropriate in any similar situation. B. The nurse has lost emotional control. C. An overreaction to a common situation. D. It is appropriate in this situation.
D. It is appropriate in this situation. A family might not welcome this behavior in some instances, but the nurse has a genuine fondness for the client and that may help family members in their own grief. Although nurses must behave with objectivity in making decisions about client care, warmth and caring are also important aspects of their work. Nursing staff should be encouraged to express their own feelings about clients' deaths.
An older client admits that the thought of dying is not pleasant, because it is an expectation that life eventually ends. What should this client's statement suggest to the nurse? A. The client intends to avoid talking about death in the future. B. The client is not ready to accept that death occurs. C. The client is delusional. D. The client has had previous experiences with death.
D. The client has had previous experiences with death. Clients' reactions to dying are influenced by previous experiences with death, age, health status, philosophy of life, and religious, spiritual, and cultural beliefs. The client's statement does not indicate that the client is delusional, is not ready to accept that death occurs, or will avoid talking about death in the future.
The nurse cares for an older client with several chronic health problems. For which situation should the nurse plan interventions to address an Alteration in Family Processes? A. hired caregiver takes the client shopping once a week B. next door neighbor visits every afternoon C. adult son works evening shift D. client's spouse passed away
D. client's spouse passed away A contributing or causative factor for the nursing diagnosis of Alteration in Family Processes would be the death of a family member. The adult son working, visiting neighbors, or caregivers taking the client shopping are not causative factors for this nursing diagnosis.
An older client that the nurse has visited periodically over several years has died. What should be done to support the nurse's feelings about the client's death? A. remind the nurse to be professional B. suggest the nurse not visit the family C. recommend the nurse avoid the funeral D. encourage the nurse to cry
D. encourage the nurse to cry The staff working with a dying patient requires a great deal of support. To encourage the nurse to cry or show emotions in other forms may be extremely beneficial. The nurse has feelings and emotions and should be permitted to demonstrate them at this time. The nurse has a relationship with the family and needs to see them at this time. Avoiding the funeral denies the nurse's relationship with the deceased client.
An older adult client dying of cancer tells a nurse, "My pain is becoming much worse." Further assessment reveals that the client rates the pain as 9 on a scale of 0 to 10. Which pain relief measure would the nurse anticipate administering? A. codeine B. tramadol C. oxycodone D. hydromorphone
D. hydromorphone The client should receive an analgesic immediately to prevent the pain from becoming even more severe. A pain rating of 9 indicates severe pain. Morphine or hydromorphone is given for severe pain. Codeine, tramadol and oxycodone are prescribed for moderate pain.
