A client with terminal cancer arrives in the emergency department unresponsive and in respiratory distress. The client's sister is the legal medical power of attorney. Both the client's spouse and sister are present. Which action by the nurse is appropriate at this time?

Question

A client with terminal cancer arrives in the emergency department unresponsive and in respiratory distress.  The client's sister is the legal medical power of attorney.  Both the client's spouse and sister are present.  Which action by the nurse is appropriate at this time?

Quizplus · Accepted Answer

Advance directives are legal documents that allow clients to make decisions about their future medical treatment in case the client later becomes medically incompetent (eg, end of life, dementia, brain injury). The most common forms are living will and medical power of attorney (POA) (ie, health care surrogate/proxy). A living will declares the client's wishes related to specific situations (eg, do not intubate). A medical POA allows the client to designate a specific decision-making individual who can advocate for the client as needed and can be flexible in changing circumstances (Option B). (Option A) A client's spouse is typically the primary decision maker. However, clients have the right to declare any specific individual who they trust as their agent with medical POA, and the agent becomes the final decision maker. (Option C) The client should receive treatment immediately if there are no advance directives or family members present, but in this case, the agent authorized with medical POA is present and should approve the treatment plan before interventions are initiated. (Option D) If the client's medical POA agent is present, treatment should not be delayed by requesting a living will as the agent will advocate for the client's wishes and has final decision-making authority. Educational objective: Medical power of attorney (POA) is an advance directive that allows clients to designate a specific decision-making individual who advocates on their behalf if they become medically incompetent. Clients have the right to declare any individual they trust as their agent with medical POA, and that individual becomes the final decision maker.

A Client with Terminal Cancer Arrives in the Emergency Department