A male client has terminal metastatic disease. He arrives at the emergency department with respirations of 6/min and an advance directive indicating to withhold resuscitative efforts. What should the nurse's response be?

Question

A male client has terminal metastatic disease.  He arrives at the emergency department with respirations of 6/min and an advance directive indicating to withhold resuscitative efforts.  What should the nurse's response be?

Quizplus · Accepted Answer

Advance directives are prepared by a client prior to the need to indicate the client's wishes. A living will gives instructions about future medical care and treatment if the client is unable to communicate. A medical power of attorney is the individual designated to make health care decisions should a client become unable to make an informed decision. It allows more flexibility to deal with unique situations. Because the client has indicated specific desires, these should be honored. This is especially true as the client has a terminal condition (versus, for example, an acute choking episode that could be easily reversed). Oxygen can provide comfort and is not resuscitative when given by nasal cannula. (Option B) Advance directives are determined ahead of time to guide decision making at the time of the event. The client can indicate a desire to make a change, and the original decision should be honored. This client could be experiencing hypoxia and thus not thinking as clearly as when the advance directives were made. Asking about changes could imply that he should make a change, which is not true. The original decision should be honored; however, the client can indicate a desire to make a change. (Option C) The client's advance directives take legal precedence over the spouse's wishes. The spouse is consulted when there are no advance directives or durable power of attorney for health care. (Option D) Advance directives include living wills with written directives on how to handle situations. A medical power of attorney is used in situations not covered by the written directives. This client has indicated his wishes. A durable power of attorney for health care is used only when clients have not expressed wishes or cannot speak for themselves. Educational objective: Advance directives include a living will (specific situations put in writing) or a medical power of attorney (an individual appointed when the clients are unable to speak for themselves). The client's wishes should be honored.

A Male Client Has Terminal Metastatic Disease