The inexperienced nurse is reassigned to another unit to care for a critically ill client whose care is beyond her capability. What action should the nurse take first?

A. This statement indicates an understanding of hospice care because hospice typically involves discontinuing aggressive treatments such as chemotherapy, radiation, or surgeries that are aimed at curing the cancer. Instead, the focus shifts to palliative care to manage symptoms and improve quality of life.

B. This statement suggests the client may not fully understand hospice care. In hospice, the emphasis is on managing symptoms in the home setting with the support of hospice nurses and caregivers. Calling 911 for symptom management contradicts the philosophy of hospice, which is to avoid aggressive interventions and hospitalizations.

C. This statement indicates a misunderstanding of hospice care. Hospice care focuses on comfort and quality of life rather than rehabilitative services such as physical therapy. In hospice, the care provided is primarily palliative and supportive rather than rehabilitative.

D This statement would indicate a misunderstanding of hospice care. In hospice, the prognosis is typically a life expectancy of six months or less if the disease follows its natural course. Hospice care is provided when curative treatments are no longer effective or desired, and the focus is on comfort rather than prolonging life.

A. Hyperkalemia can have significant cardiac effects, potentially leading to life-threatening arrhythmias such as bradycardia, heart block, ventricular tachycardia, or ventricular fibrillation. As potassium levels rise, it affects the electrical conduction of the heart, leading to changes in the ECG (electrocardiogram) and potentially causing fatal arrhythmias.

B. While hyperkalemia primarily affects the cardiovascular system, gastrointestinal symptoms can also occur. These may include nausea, vomiting, abdominal pain, and diarrhea. However, these symptoms are typically less severe compared to cardiac manifestations. Monitoring for gastrointestinal symptoms helps in assessing overall clinical status but is not as critical as assessing cardiac function in the context of hyperkalemia.

C. Respiratory symptoms are not typically associated with hyperkalemia unless severe acid-base disturbances are present. Potassium imbalance itself does not directly affect respiratory function. Therefore, while it is important to assess respiratory status in any client, it is not the priority in the context of hyperkalemia.

D. Hyperkalemia can affect the nervous system, leading to symptoms such as muscle weakness, tingling sensations, and even paralysis in severe cases. However, neurologic symptoms usually occur at higher potassium levels or in the presence of significant electrolyte imbalances affecting nerve function.

Monitoring for neurologic symptoms is important but is generally secondary to assessing cardiac status in the context of approaching severe hyperkalemia.