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 C

Explanation

"Bringing on your death in this manner would be a subject you should discuss with your family and primary care provider" (Option A): While discussing end-of-life wishes with family and healthcare providers is important, this response does not directly address the ethical issue at hand. It may be appropriate to encourage open communication and advance care planning, but administering a deliberate overdose is not ethically permissible.

"Let me have a while to consider your request" (Option B): Delaying a response to the patient's request for deliberate overdose could potentially lead to confusion and distress for the patient. Additionally, this response does not address the ethical concerns raised by the request.

"I cannot ethically give you a deliberate overdose" (Option C): This response aligns with the ethical principle of nonmaleficence, which obligates healthcare providers to avoid causing harm to patients. Administering a deliberate overdose to hasten death would violate this principle and go against the nurse's ethical obligations.

"I can contact the primary care provider and request an order for a drug that could be used as you request" (Option D): This response suggests a willingness to facilitate the patient's request for deliberate overdose, which is not ethically permissible. Administering a drug with the intention of ending a patient's life is contrary to the ethical principles of beneficence and nonmaleficence.

A. Pooling of secretions B. Shallow breathing C. Tachypnea D. Apnea

Correct Answer is A

Explanation

A. Pooling of secretions: The term "death rattle" refers to the sound produced by the pooling of secretions in the throat or airway of a dying person. This accumulation of fluids creates a rattling or gurgling sound during breathing, which is characteristic of the death rattle.

B. Shallow breathing: Shallow breathing refers to breathing that is not deep or full. While shallow breathing may occur in dying individuals, it is not specific to the death rattle.

C. Tachypnea: Tachypnea refers to rapid or fast breathing. While tachypnea may occur in various medical conditions, it is not specific to the death rattle.

D. Apnea: Apnea refers to the cessation or absence of breathing. While apnea may occur in the dying process, it is not specific to the death rattle, which is characterized by the presence of breathing accompanied by the rattling sound caused by secretions.

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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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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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