A hospice nurse is planning care for a client who is near death. Which of the following actions should the nurse include in the client’s plan of care to promote the client’s comfort?
A.
Elevate the head of the client’s bed.
B.
Offer the client ice chips.
C.
Turn the client every 4 hours.
D.
Provide oral care to the client every 6 hours.
The Correct Answer and Explanation is:
Correct Answer: A. Elevate the head of the client’s bed.
Explanation:
When planning care for a client who is near death, the primary focus is on ensuring comfort and alleviating distress. Each action in the care plan should aim to enhance the client’s comfort, manage symptoms, and provide emotional support.
- Elevate the head of the client’s bed (Option A): Elevating the head of the bed can significantly enhance the client’s comfort. This position is beneficial for several reasons. Firstly, it can help alleviate dyspnea (difficulty breathing), a common symptom in terminally ill patients. By elevating the head of the bed, the client can breathe more easily as gravity assists with lung expansion and reduces pressure on the diaphragm. This position also aids in reducing the risk of aspiration, as it keeps the head elevated and minimizes the chance of food or fluids entering the lungs. Additionally, an elevated head position can improve the client’s overall sense of comfort and can be less distressing for someone who may have decreased consciousness or fatigue.
- Offer the client ice chips (Option B): Offering ice chips might be appropriate for clients who are alert and able to take oral fluids, but it may not be suitable for clients who are near death, especially if they are no longer able to swallow or if it might cause discomfort. In some cases, it may be more appropriate to provide moistening of the lips or oral mucosa with a swab to maintain comfort.
- Turn the client every 4 hours (Option C): Regular repositioning is important to prevent pressure ulcers and improve comfort. However, for clients who are near death, turning every 4 hours might be unnecessary and could potentially cause discomfort. The frequency of turning should be adjusted based on the client’s comfort and need.
- Provide oral care to the client every 6 hours (Option D): Oral care is crucial for maintaining comfort, but the frequency should be tailored to the client’s needs and preferences. For a client near death, oral care might be required more frequently to manage dryness and discomfort, rather than every 6 hours.
In summary, elevating the head of the bed (Option A) directly addresses common symptoms and provides a significant comfort benefit to clients near the end of life.