A patient who is terminally ill has been unable to maintain good nutrition because of nausea and anorexia and has lost a great deal of weight. He is now unable to change his position in bed and needs frequent perineal care because of urinary incontinence. The nurse planning his care would include in the plan of care to:
provide laxatives and stool softeners to prevent constipation.
provide him with an air pressure mattress
coax him to eat high-calorie, high-fat food.
contact the primary care provider for an order for tube feeding.
The Correct Answer is B
Provide laxatives and stool softeners to prevent constipation (Option A): While constipation may be a concern for immobile patients, there is no indication in the scenario that the patient is currently experiencing constipation. Therefore, providing laxatives and stool softeners would not be a priority at this time.
Provide him with an air pressure mattress (Option B): This option is appropriate because the patient is immobile and at risk of developing pressure ulcers due to prolonged bed rest. An air pressure mattress helps distribute pressure evenly and reduces the risk of pressure ulcer formation, which is crucial for maintaining skin integrity and preventing complications.
Coax him to eat high-calorie, high-fat food (Option C): Although the patient is experiencing weight loss due to poor nutrition, coaxing him to eat high-calorie, high-fat food may not be appropriate if he is experiencing nausea and anorexia. This approach may exacerbate gastrointestinal symptoms and discomfort.
Contact the primary care provider for an order for tube feeding (Option D): While tube feeding may be considered if the patient is unable to meet his nutritional needs orally, it should not be the first intervention. Before considering tube feeding, other options for improving oral intake and addressing nausea and anorexia should be explored. Additionally, tube feeding may not address the patient's immobility and risk of pressure ulcers. Therefore, providing an air pressure mattress is a more appropriate intervention in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Option C is the best response because it acknowledges the patient's feelings of being a burden on her family and encourages her to express her concerns further. By asking the patient to describe what she means by burden, the nurse demonstrates empathy, active listening, and a willingness to understand the patient's perspective. This approach opens the door for therapeutic communication and allows the nurse to explore the patient's feelings and concerns more deeply.
A. "I know. I would feel terrible if I had been told I was dying." This response does not effectively address the patient's concerns or provide therapeutic communication. It shifts the focus from the patient's feelings to the nurse's hypothetical reaction, which may invalidate the patient's emotions and fail to address her immediate needs.
B. "Is there any reason to tell your family about this now? You still have some time in which you can enjoy life." This response minimizes the patient's emotions and fails to acknowledge her distress about feeling like a burden to her family. It also suggests avoiding communication with her family, which may not be in line with the patient's values or preferences regarding sharing important information.
C. "You have heard some very bad news today. Can you describe what you mean by burden?" This response acknowledges the patient's feelings and invites further discussion about her concerns. By encouraging the patient to describe her feelings of being a burden, the nurse demonstrates empathy and validates the patient's emotions, which can promote therapeutic communication and understanding.
D. "I doubt that your loving family will view your terminal care as a burden." While this response attempts to provide reassurance, it may come across as dismissive of the patient's feelings and concerns. It assumes how the patient's family will react without addressing the patient's immediate emotional needs or exploring her perspective further.
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."
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