A client, scheduled for open-heart surgery, expresses a desire not to be resuscitated if they pass away during the procedure.
What is the nurse’s subsequent course of action?
Administer the prescribed oral and intravenous pre-operative medications.
Inform the physician after the surgical procedure is complete.
Record and have a clear conversation with the client about their wishes regarding Cardio-Pulmonary Resuscitation.
Verbally communicate the client’s wishes to the supervisor of the operating room.
The Correct Answer is C
Choice A rationale:
Administering pre-operative medications does not address the client's expressed desire regarding resuscitation. It is a necessary step in preparing the client for surgery, but it does not directly relate to their preferences for end-of-life care.
Fulfilling this task does not ensure that the client's wishes are communicated to the appropriate healthcare providers, potentially leading to unwanted resuscitative efforts if the client's condition deteriorates during surgery.
It is crucial for the nurse to prioritize the client's autonomy and right to self-determination regarding their healthcare choices.
Choice B rationale:
Informing the physician after the surgery is complete is not timely and could result in the client's wishes not being respected.
The physician needs to be aware of the client's resuscitation preferences before the procedure begins to ensure that care aligns with their wishes.
Delaying communication could lead to ethical and legal dilemmas if resuscitation is attempted against the client's expressed desires.
Choice C rationale:
This is the most appropriate action because it directly addresses the client's concerns and ensures that their wishes are documented and communicated effectively.
Having a clear conversation with the client allows for exploration of their understanding of resuscitation and any potential concerns or questions they may have.
Recording the client's wishes in their medical record provides a clear record for all healthcare providers involved in their care, promoting consistency and respect for their autonomy.
Choice D rationale:
While verbally communicating the client's wishes to the operating room supervisor is important, it is not sufficient on its own.
Written documentation in the medical record is essential to ensure that the information is accurately conveyed to all members of the healthcare team and accessible throughout the client's care journey.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Brown or black urine is not a typical observation associated with Levodopa use. It can indicate other potential causes, such as: Dehydration
Liver disease
Rhabdomyolysis (muscle breakdown)
Certain medications like metronidazole or iron supplements
Hematuria (blood in the urine)
It's essential to rule out these conditions if brown or black urine is observed.
Choice C rationale:
Green or blue-green urine is also not common with Levodopa. It can be caused by:
Medications like amitriptyline, indomethacin, propofol, or methylene blue
Certain food dyes
Urinary tract infections caused by Pseudomonas bacteria
Familial benign hypercalcemia (a rare genetic condition)
Choice D rationale:
Blood-tinged urine (hematuria) is not a direct effect of Levodopa. It can signal underlying urinary tract issues, such as: Infections
Kidney stones
Bladder or kidney tumors
Trauma to the urinary tract
Strenuous exercise
Choice B rationale:
Orange or orange-red urine is the most common observation in patients taking Levodopa. This discoloration is due to: Breakdown of Levodopa into dopamine and other metabolites
These metabolites can impart an orange or reddish hue to the urine
The color intensity may vary depending on dosage and individual metabolism
It's generally harmless and doesn't require medical intervention
However, it's essential to inform healthcare providers about any urine color changes to ensure proper monitoring and rule out other potential causes.
Correct Answer is D
Explanation
Choice A rationale:
While urinary tract infections (UTIs) are a potential risk with furosemide use, they are not the most immediate or anticipated effect following initiation of the medication.
UTIs can occur due to changes in urinary flow and potential catheter use.
However, furosemide's primary action is to increase urine output, which would not directly lead to a higher risk of UTIs at the onset of treatment.
Choice B rationale:
Concentrated dark urine is typically associated with dehydration or conditions that cause the kidneys to conserve water, such as kidney disease or severe fluid loss.
Furosemide, on the other hand, is a diuretic that promotes water loss through the urine, leading to more dilute urine.
Choice C rationale:
Transient incontinence can occur with furosemide due to the rapid increase in urine production, but it is not the most predictable or anticipated effect.
Increased urine production is expected, but transient incontinence may or may not occur in all patients.
Choice D rationale:
This is the most accurate and anticipated response.
Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidneys.
This leads to a significant increase in urine output, often within a few hours of administration. The urine produced is typically dilute and light-colored, as it contains a higher concentration of water and electrolytes. This is the intended effect of furosemide, as it helps to reduce fluid overload and edema.
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