Ethical and Legal Considerations in End-of-Life Care
Ethical and Legal Considerations in End-of-Life Care ( 4 Questions)
A client who has a do-not-resuscitate (DNR) order is admitted to the hospital with pneumonia. The client develops respiratory distress and requires intubation and mechanical ventilation. The nurse notices that the DNR order is not documented in the electronic health record (EHR). What should the nurse do?
Intubate and ventilate the client, as the DNR order is not valid without documentation in the EHR. - This is an incorrect option, as intubating and ventilating the client would violate their right to refuse treatment and die naturally. The DNR order is valid even if it is not documented in the EHR, as long as it is written by a physician and signed by the client or their surrogate decision-maker.
Contact the physician who wrote the DNR order and ask them to enter it in the EHR as soon as possible. - This is an incorrect option, as contacting the physician who wrote the DNR order would delay providing appropriate care to the client. The nurse should verify and document the DNR order themselves, as they are accountable for following it.
Refuse to intubate and ventilate the client, as the DNR order is valid regardless of documentation in the EHR. - This is an incorrect option, as refusing to intubate and ventilate the client without verifying and documenting the DNR order would put the nurse at risk of legal liability and professional misconduct. The nurse should ensure that there is evidence of the DNR order in the EHR before acting on it.
The nurse should verify the DNR order with the client or their surrogate decision-maker and document it in the EHR before proceeding. The nurse should ensure that the DNR order is clear, current, and consistent with the client's wishes and goals of care. The nurse should also communicate the DNR order to other members of the health care team.
Rationale: The nurse should verify the DNR order with the client or their surrogate decision-maker and document it in the EHR before proceeding. The nurse should ensure that the DNR order is clear, current, and consistent with the client's wishes and goals of care. The nurse should also communicate the DNR order to other members of the health care team.
Incorrect options:
A) Intubate and ventilate the client, as the DNR order is not valid without documentation in the EHR. - This is an incorrect option, as intubating and ventilating the client would violate their right to refuse treatment and die naturally. The DNR order is valid even if it is not documented in the EHR, as long as it is written by a physician and signed by the client or their surrogate decision-maker.
B) Contact the physician who wrote the DNR order and ask them to enter it in the EHR as soon as possible. - This is an incorrect option, as contacting the physician who wrote the DNR order would delay providing appropriate care to the client. The nurse should verify and document the DNR order themselves, as they are accountable for following it.
C) Refuse to intubate and ventilate the client, as the DNR order is valid regardless of documentation in the EHR. - This is an incorrect option, as refusing to intubate and ventilate the client without verifying and documenting the DNR order would put the nurse at risk of legal liability and professional misconduct. The nurse should ensure that there is evidence of the DNR order in the EHR before acting on it.