A client on the cardiac telemetry unit suddenly starts showing signs of ventricular fibrillation. The advanced cardiac life support (ACLS) team defibrillates the client, restoring a normal sinus rhythm. Later in the day, a family member Questions why the code was called, telling the nurse that the client has a living will.
How should the nurse respond?
A.
Schedule a client and family conference to review the plan of care.
B.
Explain that living wills cannot be followed by emergency personnel.
C.
Check the client’s arm for a “Do Not Resuscitate” (DNR) bracelet.
D.
Seek clarification of the type of advance directive the client has.
The correct answer and Explanation is :
The best response in this situation would be:
D. Seek clarification of the type of advance directive the client has.
Explanation:
When a client is admitted to the hospital, especially in a critical condition, their advance directives and any other legal documents regarding their care preferences should be carefully reviewed and respected. If a client has a living will or other advance directive that specifies their wishes about medical treatments, including resuscitation efforts, it is crucial to verify and adhere to these instructions.
In this scenario, the client displayed signs of ventricular fibrillation, a life-threatening arrhythmia that requires immediate intervention. The ACLS team’s decision to defibrillate was based on the need to restore a normal heart rhythm to preserve life. However, if the client had a living will or another type of advance directive indicating that they did not want resuscitation efforts, this directive should have guided the medical team’s actions.
To address the family member’s concerns effectively:
- Clarify the Advance Directive: It is important to confirm the specifics of the client’s advance directive, including whether it includes a “Do Not Resuscitate” (DNR) order or other instructions related to emergency interventions. This ensures that the medical team’s actions align with the client’s wishes.
- Verify Documentation: Check the client’s medical records for any advance directives or legal documents that indicate their preferences. These documents should be readily accessible to guide medical decisions.
- Communicate Clearly: Once you have confirmed the client’s directives, you can provide a clear explanation to the family member about the situation. If it turns out that the client’s wishes were not followed, it’s crucial to discuss why this might have happened, such as if the documents were not readily available or if there was an immediate need to act based on the information available at the time.
By seeking clarification and verifying the client’s wishes, you ensure that the care provided respects their legal and personal preferences while also addressing the family’s concerns comprehensively.