A licensed practical/vocational nurse is caring for a client with end-stage lung cancer
The client is tired of receiving palliative care (providing comfort by relieving symptoms, but no hope for cure, or to prolong life) along with chemotherapy and radiation treatments. The client states a desire to die peacefully in his home with his family. The client's multidisciplinary team consists of the licensed practical/vocational nurse, a registered nurse clinical specialist in oncology, a pulmonologist, an oncologist, a respiratory care practitioner, a psychologist, and a social worker. To best care for the client, the licensed practical/vocational nurse should call:
A) for a team meeting to discuss the client's request and to best determine what team members and resources are needed to meet the client's request.
B) the psychologist to discuss that the client is exhibiting symptoms of depression and ask for recommendations.
C) hospice so their multidisciplinary team may meet the client's requests with a hospice nurse, hospice physician, social worker, and clergy.
D) the oncologist to discuss the client's request and ask for a "do not resuscitate" status and discharge the client to his home.
Ans: A
Feedback:
Multidisciplinary teams are made up of health care workers with different areas of expertise, all working together to benefit the client. In this case, the client no longer wants palliative chemotherapy and radiation measures but wants to die peaceably at home with his family, so with this change in care needs, a multidisciplinary team meeting is appropriate so the team may work together to provide the best comfort for the client in his home. The client exhibits no signs or symptoms of depression, so calling the psychologist is inappropriate. Calling the oncologist for discharge orders and "do not resuscitate" order leaves out the input from the other team members. The oncologist would most likely call the team meeting. The nurse should not supersede the existing team to call another multidisciplinary team to take over the client's care.
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