The patient has a colostomy but has not yet been able to look at it. The nurse teaches the patient how to care for the colostomy. The nurse sits with the patient and together they form a plan on how to approach dealing with colostomy care. Which caring process is the nurse performing?

Choice A reason: Cheyne-Stokes breathing, alternating cycles of deep breathing and apnea, is a hallmark of impending death, often seen in the final hours. It reflects brainstem dysfunction as the body shuts down. This finding signals the nurse to prepare the family for imminent death, providing emotional support and guidance.

Choice B reason: Redness of skin may indicate pressure injuries or fever but is not a specific sign of imminent death. In the dying process, skin may become mottled or pale, not red. This finding does not prompt immediate preparation for death, making it an incorrect choice.

Choice C reason: Tense muscle tone is not typical in the last stages of dying, where muscles relax due to metabolic shutdown. Rigidity occurs post-mortem (rigor mortis). This finding does not indicate imminent death, so it does not require preparing the family, making it incorrect.

Choice D reason: Clear colored urine reflects hydration but is not a sign of impending death. In the dying process, urine output decreases, and color darkens due to reduced renal perfusion. This finding is irrelevant to preparing the family for death, as it does not signal the final stages.

Choice A reason: Knowing involves understanding the patient’s experiences and needs, not actively forming a care plan together. Enabling focuses on empowering the patient through collaboration, as seen here. Assuming knowing risks underemphasizing the patient’s active role, potentially limiting empowerment and self-efficacy critical for colostomy care acceptance and management.

Choice B reason: Doing for involves performing tasks for the patient, not collaborating on a plan, as with enabling. The nurse’s joint planning empowers the patient to manage colostomy care. Assuming doing for overlooks patient autonomy, risking dependency and reduced confidence in self-care, critical for long-term colostomy management and adaptation.

Choice C reason: Enabling, per Swanson’s caring theory, involves facilitating the patient’s capacity to manage their care through collaboration, as seen in forming a colostomy care plan together. This empowers the patient, fostering confidence and acceptance. Enabling supports self-efficacy, critical for psychological adjustment and practical management of a new colostomy, enhancing patient outcomes.

Choice D reason: Maintaining belief sustains hope and values but doesn’t involve collaborative planning, unlike enabling. The nurse’s focus is empowering practical colostomy care, not spiritual support. Assuming maintaining belief misaligns with the action, potentially neglecting the patient’s need for active involvement in learning and adapting to colostomy self-care.