A patient with heart failure is facing the end of life. Which intervention would the nurse prioritize with this patient?
1. Have the health care provider discuss end-of-life topics with the patient.
2. Tell the patient that the family should be the primary source of support, but that nursing staff will be glad to substitute if necessary.
3. Be as honest as possible about the progression of the disease and the support needed.
4. Reassure the patient that death will be painless.
3
Rationale 1: The health care provider will be involved in end-of-life discussions, but as a patient advocate the nurse can certainly discuss end-of-life options with the patient.
Rationale 2: Telling the patient that the nursing staff will "substitute" for family implies that the family is not fulfilling its role.
Rationale 3: The heart failure patient who is nearing the end of life will need honest discussions regarding the progression of the disease and the support needed and available.
Rationale 4: The nurse cannot promise a painless death for this patient.
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