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Zorluk: OrtaEnd of Life Care

A community health nurse is conducting a home visit for an older adult client receiving hospice care for terminal prostate cancer. The client is currently unresponsive and has been sleeping for the past 18 hours. The client's partner is visibly anxious and states, 'He never used to sleep this much. I am worried his dementia is suddenly progressing, or maybe this is just what happens when people get old.' Which of the following is the most appropriate response by the nurse?

  1. A
    This is a normal physiological change. As individuals reach advanced age, it is completely normal for them to sleep for most of the day.
  2. B
    I can assign the nursing assistant to stay at his bedside and perform ongoing neurological assessments to track his level of consciousness.
  3. It is understandable to be concerned. This increased sleepiness is an expected part of the body slowing down from the cancer, rather than just aging or dementia.Cevap
  4. D
    Why are you letting this worry you? It is actually better that he is sleeping peacefully and not experiencing any severe pain right now.

Cevap

The most appropriate response is to validate the partner's concerns and educate them that increased sleepiness is an expected part of the body slowing down from the terminal illness.
The correct response directly addresses the partner's concern, validates their feelings, and provides accurate education about the dying process. In the terminal phase of an illness, physiological slowing of the body leads to increased time spent sleeping and decreased responsiveness. Providing this context helps alleviate anxiety and corrects the misconception that the changes are due to dementia or normal aging.

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1
Analyze the client's clinical presentation.
The client is in hospice care for a terminal illness and is exhibiting increased sleepiness and unresponsiveness.
Understanding the clinical context (active dying phase) is necessary to determine the expected physiological changes.
2
Evaluate the partner's statement and emotional state.
The partner is anxious and misattributing the symptoms to worsening dementia or normal aging.
Identifying the partner's knowledge deficit and emotional distress guides the therapeutic response.
3
Assess the provided options against principles of therapeutic communication, palliative care, and safe nursing practice.
The option validating the concern and educating about the dying process is the only one that uses therapeutic communication and provides accurate clinical information.
Eliminating non-therapeutic responses, inaccurate medical information, and unsafe delegation leads to the correct nursing action.

Anahtar Kavram

Therapeutic Communication and Education in End of Life Care
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Konular

End of Life Care

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