Legal and Documentation Considerations in End-of-Life Care
Legal and Documentation Considerations in End-of-Life Care ( 7 Questions)
A nurse is reviewing the medical record of a client who has a do-not-resuscitate (DNR) order. The nurse notes that the order was written by the physician after consulting with the client's health care proxy, who is the client's adult daughter. The nurse also notes that the client is alert and oriented and has not expressed any objections to the DNR order.
What is the appropriate action by the nurse in this situation?
The appropriate action by the nurse in this situation is to confirm the DNR order with
the client and document the conversation in the medical record. The nurse should ensure that
the client understands what a DNR order means and that they agree with it. The nurse should
also respect the client's right to change their mind at any time and revoke the DNR order if they wish.
Contact the physician and request that the DNR order be revoked, as the client has not given consent. - This is an inappropriate action, as it would violate the client's autonomy and dignity. The nurse should not assume that the client has not given consent, as they may have discussed their wishes with their health care proxy or physician beforehand. The nurse should confirm the DNR order with the client instead of requesting its revocation.
Respect the DNR order and provide palliative care to the client, as the health care proxy has authority to make decisions. - This is a partially correct action, as the nurse should respect the DNR order and provide palliative care to the client. However, the nurse should not rely solely on the health care proxy's authority to make decisions, asthe client is alert and oriented and may have their own preferences and opinions. The nurse should confirm the DNR order with the client as well.
Ignore the DNR order and initiate resuscitation measures if the client experiences cardiac or respiratory arrest, as the order is invalid. - This is an inappropriate action, as it would violate the client's rights and wishes. The nurse should not ignore the DNR order, as it is a valid and legal document that indicates the client's choice regarding resuscitation measures. The nurse should respect the DNR order and confirm it with the client.
Rationale: The appropriate action by the nurse in this situation is to confirm the DNR order with
the client and document the conversation in the medical record. The nurse should ensure that
the client understands what a DNR order means and that they agree with it. The nurse should
also respect the client's right to change their mind at any time and revoke the DNR order if they wish.
Incorrect options:
B) Contact the physician and request that the DNR order be revoked, as the client has not given consent. - This is an inappropriate action, as it would violate the client's autonomy and dignity. The nurse should not assume that the client has not given consent, as they may have discussed their wishes with their health care proxy or physician beforehand. The nurse should confirm the DNR order with the client instead of requesting its revocation.
C) Respect the DNR order and provide palliative care to the client, as the health care proxy has authority to make decisions. - This is a partially correct action, as the nurse should respect the DNR order and provide palliative care to the client. However, the nurse should not rely solely on the health care proxy's authority to make decisions, asthe client is alert and oriented and may have their own preferences and opinions. The nurse should confirm the DNR order with the client as well.