The nurse is caring for a client who is discussing being placed on hospice care. Which statement by the client indicates an understanding of hospice care?

A. Isotonic solutions have a similar osmolarity to that of blood plasma, meaning they exert the same osmotic pressure as blood. This equilibrium prevents the movement of water across cell membranes, thereby maintaining cell volume and preventing cellular dehydration or swelling. Examples of isotonic solutions commonly used for intravenous fluid replacement include 0.9% saline (normal saline) and lactated Ringer's solution.
B. Hypotonic solutions have a lower osmolarity than blood plasma, meaning they exert less osmotic pressure than blood. When administered, hypotonic solutions cause water to move into cells, leading to cellular swelling. While hypotonic solutions can help hydrate cells and replenish intracellular fluid, they are not typically used for rapid volume replacement because they can exacerbate extracellular fluid deficits and cause complications such as cerebral edema or cardiovascular collapse.
C. Hypertonic solutions have a higher osmolarity than blood plasma, meaning they exert greater osmotic pressure than blood. When administered, hypertonic solutions cause water to move out of cells, leading to cellular shrinkage. Hypertonic solutions are often used to expand intravascular volume in cases of severe hypovolemia or shock, as they rapidly increase blood osmolarity and draw fluid from the interstitial space into the bloodstream. Examples of hypertonic solutions include 3% saline and 5% dextrose in 0.9% saline.
D. Hyperosmotic solutions have an elevated osmolarity compared to blood plasma, indicating a higher concentration of solutes. These solutions exert osmotic pressure that draws water out of cells, leading to cellular dehydration. While hyperosmotic solutions are not commonly used for rapid volume replacement due to their pot

D. This statement indicates an understanding of hospice care. Pain management is a crucial component of hospice care, and ensuring that patients have access to effective pain medication and symptom management is a priority. Hospice aims to maximize comfort and quality of life for patients, and providing pain relief is a fundamental aspect of this approach.
A. This statement suggests that the client may not fully understand the purpose of hospice care. Hospice care is generally provided to patients with a terminal illness who have a life expectancy of six months or less. The focus of hospice care is on comfort, quality of life, and symptom management rather than curative treatment. Planning for travel and activities like fishing may not align with the goals of hospice care.
B. This statement indicates a misunderstanding of hospice care. In hospice, patients are typically encouraged to have their loved ones and family members present and involved in their care, especially during the end-of-life period. Hospice care emphasizes emotional support, spiritual care, and the importance of family involvement during the dying process.
C. This statement may or may not indicate an understanding of hospice care, as it depends on the specific hospice setting and individual preferences. While some hospice programs may provide care in a hospital setting, many hospice services are delivered in the patient's home or in a hospice facility. The key aspect of hospice care is to provide comfort and support in a setting that best meets the patient's needs and wishes.