A hospice nurse is caring for a client who is approaching death and has fecal incontinence. Which of the following actions should the nurse take?

Request a prescription for lactulose from the provider.

Place an occlusive dressing over the client's buttocks every 8 hr.

Insert a lubricated rectal tube gently.

Keep disposable undergarments clean and dry.

Answer and Explanation

The Correct Answer is D

A. Request a prescription for lactulose from the provider: Lactulose is a laxative commonly used to treat constipation, but it is not appropriate for managing fecal incontinence in a hospice client approaching death. It focuses on promoting bowel movements rather than managing incontinence.

B. Place an occlusive dressing over the client's buttocks every 8 hr: Occlusive dressings are not typically used for managing fecal incontinence. They may trap moisture and exacerbate skin breakdown, especially in a hospice client who may be immobile or bedridden.

C. Insert a lubricated rectal tube gently: Inserting a rectal tube is invasive and may cause discomfort or injury, especially in a client who is approaching death. It is not recommended for managing fecal incontinence in this situation.

D. Keep disposable undergarments clean and dry: This is the most appropriate action for managing fecal incontinence in a hospice client. Keeping disposable undergarments clean and dry helps maintain skin integrity and prevents skin breakdown and discomfort. It also promotes comfort and dignity for the client during this sensitive time.

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Correct Answer is B

Explanation

A. Final: This option does not correspond to any stage of the grieving process or Kubler-Ross's stages of dying.

B. Acceptance: In Kubler-Ross's stages of dying, acceptance is the final stage. When a dying patient verbalizes that they are "ready," it suggests they have reached a level of acceptance regarding their impending death.

C. Bargaining: Bargaining is a stage where individuals attempt to negotiate or make deals to change the outcome of their situation. It typically occurs before acceptance in the stages of dying.

D. Denial: Denial is one of the initial stages where individuals refuse to accept the reality of their situation. It does not correspond to a dying patient indicating they are "ready."

A. Have no friends among the unit staff B. Have not come to terms with their own mortality C. Did not foresee that the illness was terminal D. Cared for the patient for several days

Correct Answer is B

Explanation

A. Have no friends among the unit staff: While having friends among the unit staff can provide emotional support, it is not directly related to a nurse's ability to cope with patient deaths. Support from colleagues can be helpful, but it is not the primary factor influencing a nurse's response to patient deaths.

B. Have not come to terms with their own mortality: This option addresses a significant factor in how nurses cope with patient deaths. Nurses who have unresolved issues or anxiety about their own mortality may find it challenging to deal with the deaths of their patients. Facing one's mortality is an essential aspect of developing resilience in the face of death and dying.

C. Did not foresee that the illness was terminal: While it can be emotionally challenging when a patient's illness unexpectedly becomes terminal, nurses are trained to provide care and support regardless of the prognosis. The ability to cope with patient deaths extends beyond foreseeing the terminal nature of an illness.

D. Cared for the patient for several days: The duration of care provided to a patient may influence the depth of the nurse's emotional connection but does not necessarily determine their ability to cope with patient deaths. Nurses develop coping mechanisms and emotional resilience through experience, training, and self-awareness, rather than simply through the length of time caring for a patient.

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A hospice nurse is caring for a client who is approaching death and has fecal incontinence. Which of the following actions should the nurse take?

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Explanation

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