The practical nurse (PN) has been regularly assigned the care of an older adult client who resides in a long term care facility. When the client is told that they have a terminal illness, which action is best for the PN to take?

• 1. 21 to 24%: The client’s fat intake for the three days totals approximately 69 grams of fat (24g + 22g + 23g), which, when multiplied by 9 calories per gram, equals about 621 calories from fat. Given the total caloric intake of 3,200–3,310 calories per day, fat constitutes approximately 21% to 24% of the total caloric intake, which is within the recommended range for a balanced diet.
• 2. has an appropriate fat intake for calories: The fat intake of 21% to 24% of total calories aligns with the general dietary recommendation, which is for 20% to 35% of total calories to come from fat. Therefore, the client’s fat intake is appropriate and does not require any adjustments.

• 1. 26 to 28%: This percentage would be too high for the client’s daily fat intake. To reach 26% to 28% of calories from fat, the client would need to consume more grams of fat. Based on the actual fat intake (69g), this range is not appropriate.
• 1. 14 to 19%: A fat intake of 14% to 19% would be considered lower than the recommended range, and would suggest the client is consuming too little fat for a balanced diet. Given the actual fat intake, this percentage is not accurate.
• 2. should increase his fat intake: Given that the client’s fat intake is already within the recommended 20%–35% range, there's no need for the client to increase his fat intake. Therefore, this option is not appropriate.
• 2. should reduce his fat intake: Reducing the client’s fat intake is not necessary, as the fat intake falls within the recommended range. A reduction in fat would lower the total percentage of calories from fat below the suggested 20%–35% range, which could be harmful for overall nutrition.
• 2. should decrease his caloric intake: There’s no indication that the client is consuming an excessive amount of calories based on the information provided. His calorie intake seems appropriate for his needs. Decreasing caloric intake isn't necessary, especially when his fat intake is within the normal range.

A. Medications are limited to managing pain: While pain management is a key component of hospice care, medications are not limited only to pain management. Hospice care also addresses other symptoms like shortness of breath, nausea, and anxiety to improve comfort.
B. Care can be provided in the home: Hospice care can indeed be provided in the home, allowing the client to remain in a familiar environment while receiving palliative care. This is a central aspect of hospice services.
C. Care focuses on quality of life at the end of life: Hospice care prioritizes comfort and quality of life, providing emotional, spiritual, and physical support for both the client and family at the end of life.
D. Curative measures are optional: In hospice care, curative treatments are typically discontinued because the focus shifts to palliative care aimed at comfort and symptom relief rather than attempting to cure the illness.
E. Family is responsible for care decisions: While families are involved in decisions, hospice care involves collaboration with the healthcare team, and decisions are made based on the patient's wishes and comfort, not solely by the family.