What should the nurse do when considering best practice?
During her morning assessment, a nurse notes that a client has severe dyspnea; his respirations are 34 breaths/minute and labored. Oxygen saturation is 79% on 3 L of oxygen. The nurse remembers that the client's chart includes his living will.
A. Withhold all potentially life-prolonging treatments in accordance with the client s living will. B. Increase the oxygen flow rate to 4 L, but avoid initiating other interventions. C. Call the client s family and ask what they think is best. D. Initiate potentially life-prolonging treatment unless the client refuses.
Dyspnea is a problem commonly experienced by people who have asthma, pneumonia or other problems. This is because it means that the person is experiencing shortness of breath where the person feels that they can’t catch their breath.
When someone has trouble breathing, then he or she may have other symptoms like chest pains. If a nurse is making her rounds in the morning, she comes across her patient who has severe dyspnea. She or he monitors his breathing and notices that he is taking almost thirty breaths per minute and it is difficult for him.
She measures the oxygen saturation as seventy-nine percent of three liters of oxygen. The patient will receive life-prolonging treatment until he refuses and according to his living will.
Initiate potentially life-prolonging treatment unless the client refuses.-rationale: a living will doesnt go into effect unless the client is unable to make his own decisions. a nurse shouldnt withhold care for an alert client unless he specifically refuses care. the nurse should give all appropriate care while also maintaining the clients right to refuse treatment. increasing the oxygen flow rate might be an appropriate response, but it isnt the best action at this time. the family isnt responsible for determining care at this time.client needs category: safe, effective care environmentclient needs subcategory: management of carecognitive level: analysisreference: craven, r.f., and hirnle, c.j. fundamentals of nursing: human health and function, 5th ed. philadelphia: lippincott williams & wilkins, 2007, p. 92.