Your client is in the special care area of your hospital with multiple trauma and severe bodily burns. This 45 year old male client has an advance directive that states that the client wants all life saving measures including cardiopulmonary resuscitation and advance cardiac life support, including mechanical ventilation. As you are caring for the client, the client has a complete cardiac and respiratory arrest. This client has little of no chance for survival and they are facing imminent death according to your professional judgement, knowledge of pathophysiology and your critical thinking. You believe that all life saving measures for this client would be futile. What is the first thing that you, as the nurse, should do?
Call the doctor and advise them that the client’s physical status has significantly changed and that they have just had a cardiopulmonary arrest.
Begin cardiopulmonary resuscitation other emergency life saving measures.
Notify the family of the client’s condition and ask them what they should be done for the client.
Insure that the client is without any distressing signs and symptoms at the end of life.
Correct Response: B
You must immediately begin cardiopulmonary resuscitation and all life saving measures as requested.by the client in their advance directive despite the nurse’s own beliefs and professional opinions. Nurses must uphold the client’s right to accept, choose and reject any and all of treatments, as stated in the client’s advance directive.
You would not call the doctor first; your priority is the sustaining of the client’s life; you would also not immediately notify the family for the same reason and, when you do communicate with the family at a later time, you would not ask them what should or should not be done for the client when they wishes are already contained in the client’s advance directive.
Finally, you would also insure that the client is without pain and all other distressing signs and symptoms at the end of life, but the priority and the first thing that you would do is immediately begin cardiopulmonary resuscitation and all life saving measures as requested by the client in their advance directive, according to the ABCs and Maslow’s Hierarchy of Needs.