A client with end-stage liver disease is admitted for a transplant workup. The client's spouse states that the client has not stopped drinking alcohol and may be unable to quit for 6 months before the transplant. Which is the most appropriate action for the nurse to implement?

Question

Quizplus · Accepted Answer

The client may not be an appropriate transplant candidate due to his alcohol use. However, additional facts are needed to determine the true situation as the only information obtained came from the client's spouse. The nurse should assess the client's drinking habits and motivation to stop drinking before and after the transplant by speaking with the client directly. In addition, a transplant requires many other self-care regimens. The nurse should be alert for indicators of the client's ability to take prescribed medications, follow dietary restrictions, and attend medical appointments. The information obtained from this assessment should be communicated to the interdisciplinary team members responsible for determining transplant eligibility. (Option A) Transplant and hospice care are options for the client with end-stage liver disease; palliative specialists can assist with identifying the goals of care and facilitating decision-making. However, this does not directly address the concern of the client's spouse. At this time, further assessment is necessary before appropriate interventions can be planned. (Option C) At this point, it is unclear whether the client is motivated to quit drinking (the nurse has only heard from the spouse). Therefore, it is premature to plan for this type of intervention. The client will need to stay sober not just prior to the surgery, but for a lifetime if the transplant occurs. Any discussion between the client's family and the medical team should be based on this understanding. (Option D) If the nurse is concerned about transplant eligibility due to the spouse's statement, then this should be communicated to the client's interdisciplinary team after further assessment. At this point, it is premature to involve the nurse manager. Educational objective: The client with end-stage organ failure must be motivated and able to engage in complex self-care regimens before and after solid organ transplant. Concerns about the client's motivation to engage in necessary self-care requirements (eg, alcohol abstinence) require further assessment.

A Client with End-Stage Liver Disease Is Admitted for a Transplant