A nurse is recording the intake and output (I&O) for a client.

The client consumed 8 oz of milk, 10 oz of water, 4 oz of gelatin, 1 egg, 1 piece of bacon, and 2 biscuits.

Which volume should the nurse record on the I&O?

Choice A rationale

This statement indicates that the client understands advance directives allow them to make decisions about their care while they are still capable. This reflects the purpose of advance directives, which is to respect and uphold the client’s autonomy and choices regarding their medical care.

Choice B rationale

This statement is incorrect because clients can change their advance directives or living will at any time. The purpose of these documents is to provide flexibility and ensure that the client's current wishes are followed.

Choice C rationale

This statement is incorrect. Once a living will is signed and witnessed or notarized, it becomes legally binding without a waiting period. The delay mentioned here is not a part of the advance directive process.

Choice D rationale

This statement is not accurate. A living will usually includes decisions about life support, and a separate consent form is not typically needed for those decisions. The client’s wishes regarding life support would be documented in the living will itself.

Choice A rationale

Encouraging a partner to eat three large meals each day may not be appropriate in end-of-life care. Clients often have reduced appetite, and small, frequent meals are usually recommended to avoid overwhelming them.

Choice B rationale

Opioids are commonly used in end-of-life care to manage pain and distress. Even if respiratory distress occurs, opioids are not typically restricted, but rather adjusted to balance pain relief and respiratory function.

Choice C rationale

Using an electric blanket can pose safety risks, including burns or electrical hazards, especially if the client is unable to communicate discomfort. Instead, alternative methods such as warm blankets are safer.

Choice D rationale

Assuming the partner can hear even if they do not respond is important. Hearing is believed to be one of the last senses to fade, and speaking to the client can provide comfort and connection.