A nurse is caring for a client in the emergency department who is actively dying from a catastrophic injury. Which of the following is the priority in planning care for this client?

Discussing organ donation with the family

Communicating sensitively with the client and family

Creating a plan for pain relief, nutrition, and hydration

Contacting the family's spiritual advisor

Answer and Explanation

The Correct Answer is B

A. "Discussing organ donation with the family": While organ donation is important, it is not the priority in the setting of an actively dying client. The primary concern at this stage should be addressing the immediate needs of the client and their family, focusing on emotional support and comfort.
B. "Communicating sensitively with the client and family.": When caring for a client who is actively dying, providing emotional support and clear communication with the family is critical. Sensitively addressing the family’s concerns and the client’s comfort is essential in this stage of care.
C. "Creating a plan for pain relief, nutrition, and hydration.": While ensuring pain relief is important, in the context of an actively dying patient, the focus should primarily be on comfort rather than ongoing interventions like nutrition and hydration, which may no longer be beneficial.
D. "Contacting the family's spiritual advisor.": While spiritual support is valuable, it should not be the first priority. Ensuring the client’s comfort and providing emotional support to the family should be prioritized initially, and the spiritual advisor can be contacted afterward if desired.

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Correct Answer is C

Explanation

A. An accumulation of fluid in the pericardial space leads to hardening of the cardiac ventricles: Cardiac tamponade is characterized by fluid accumulation in the pericardial space, which compresses the heart, preventing it from expanding fully. Hardening of the ventricles is not a primary feature of this condition.
B. Additional fluid collects in the pericardial space and systemic venous pressure decreases: In fact, as fluid accumulates in the pericardial space, systemic venous pressure actually increases because the heart struggles to pump blood effectively due to the compression.
C. Rapid accumulation of fluid around the heart causes hemodynamic changes to occur: The rapid buildup of fluid in the pericardium places pressure on the heart, causing significant hemodynamic changes like decreased cardiac output, which can result in shock.
D. Pericardial fluid accumulation causes life-threatening circulatory failure: Although fluid accumulation in the pericardium can lead to circulatory failure, this is a more general statement. The immediate concern is the hemodynamic changes (such as reduced stroke volume and compromised cardiac output) that result from the fluid buildup.

A. Chronic pulmonary disease B. Rheumatic fever C. Body mass index of 35 D. History of venous thrombosis

Correct Answer is C

Explanation

A. Chronic pulmonary disease: Chronic pulmonary disease, such as COPD, affects the lungs and respiratory system but is not a primary risk factor for peripheral artery disease (PAD), which is caused by atherosclerosis affecting peripheral circulation.
B. Rheumatic fever: Rheumatic fever is associated with inflammatory damage to the heart valves due to a streptococcal infection, but it does not increase the risk of developing PAD, which is vascular in nature and primarily driven by atherosclerotic risk factors.
C. Body mass index of 35: A BMI of 35 indicates obesity, which significantly increases the risk for atherosclerosis and related conditions like PAD. Obesity contributes to poor lipid profiles, hypertension, and insulin resistance, all of which promote arterial narrowing and plaque buildup.
D. History of venous thrombosis: Venous thrombosis affects the venous system and is different from arterial disease. While it may signal vascular issues, it is not considered a direct risk factor for PAD, which involves arterial—not venous—occlusion.

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A nurse is caring for a client in the emergency department who is actively dying from a catastrophic injury. Which of the following is the priority in planning care for this client?

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