A nurse is making a home care visit to a client with a hearing deficit.
What is the best thing she can do to facilitate communication with the client?

Choice A rationale

While nurses are generally expected to follow physician's orders, they also have a professional and ethical responsibility to advocate for their patients. In situations where an order conflicts with the patient's wishes and ethical principles, blindly following the order can lead to moral distress.

Choice B rationale

The physician's order, which contradicts the patient's explicit request, can indeed create a barrier to establishing an effective nurse-client relationship built on trust and respect for the patient's autonomy. The nurse may feel conflicted in carrying out an unwanted intervention.

Choice C rationale

The situation creates an ethical dilemma for the nurse because there are conflicting courses of action with moral implications. The nurse faces a conflict between the duty to follow the physician's order and the ethical principle of respecting the patient's autonomy and right to refuse treatment, even life-sustaining measures at the end of life.

Choice D rationale

The nurse is not unable to provide care but faces a complex ethical challenge in determining the most appropriate and ethical course of action that respects the patient's wishes while navigating the physician's order.

Choice A rationale

Anticipatory grieving is a normal psychological process of acknowledging and preparing for an expected loss. The family's expression of sorrow and crying directly indicates their emotional response to the impending death of their loved one, aligning with the defining characteristics of anticipatory grieving. This diagnosis acknowledges the family's current emotional state in relation to the anticipated loss.

Choice B rationale

Dysfunctional grieving implies an abnormal or maladaptive grief response. Age regression, while a potential manifestation of extreme stress, is not a typical or expected behavior in anticipatory grief. Without further evidence of significantly impaired functioning or prolonged, intense reactions disproportionate to the situation, labeling the grieving as dysfunctional is not supported.

Choice C rationale

Potential for grieving suggests a risk for developing grief, but the family members are already actively expressing sorrow, indicating that grieving has commenced, not just a potential for it. While crying is an expression of sorrow associated with grieving, insomnia, without further context, is a non-specific symptom and does not solely indicate anticipatory grieving related to loss.

Choice D rationale

Dysfunctional grieving, as mentioned before, implies a maladaptive response. While anxiety can be a component of grief, behaviors solely indicating anxiety do not necessarily define dysfunctional grieving related to the loss of a family member. The family's primary expression is sorrow, which is a typical component of anticipatory grief, not necessarily dysfunctional.