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Difficulty: MediumEnd of Life Care

A client with end-stage renal disease has made the decision to discontinue hemodialysis and transition to hospice care. The client's parent is visibly distraught, approaches the nurse in the hallway, and states, "You have to talk some sense into them! They cannot just give up and die." Which response by the nurse is the most therapeutic?

  1. A
    This is a very difficult situation, but you need to respect the choice your child has made.
  2. It sounds like you are feeling completely overwhelmed by this decision. Let's sit down and talk about it.Answer
  3. C
    Why do you feel that transitioning to hospice care means they are giving up?
  4. D
    I will contact the palliative care physician to come and explain the prognosis to you again.

Answer

The most therapeutic response reflects the parent's feelings of being overwhelmed and offers the nurse's presence to talk about those feelings.
The correct answer acknowledges the parent's emotional state without judgment and offers the nurse's time and presence. This approach builds trust and allows the parent to process their grief, which is a critical nursing intervention in end-of-life care.

Step-by-Step Solution

1
Analyze the parent's statement and underlying emotion.
The parent is expressing intense distress, grief, and a feeling of loss of control over the client's decision to stop life-prolonging treatment.
Identifying the core emotion is necessary to choose a response that validates the parent's feelings rather than arguing facts.
2
Evaluate the options for therapeutic and non-therapeutic communication techniques.
The correct response must use validating, open-ended techniques. Options that use 'why', give advice, or deflect the conversation are incorrect.
Therapeutic communication in end-of-life care focuses on active listening, empathy, and offering self.

Key Concept

Therapeutic Communication in End of Life Care
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Topics

End of Life Care

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