A 78 year-old patient on peritoneal dialysis for 3 years informs the nurse that he is tiring of dialysis. He further states that he has lived a good life and no longer wishes to continue with dialysis and battle the complication of diabetes
The nurse's best response to the patient is:
A) "Once you start dialysis, you cannot choose to stop the treatment."
B) "If you tire of performing peritoneal dialysis, we recommend that you change to hemodialysis or wait for a kidney transplant."
C) "Your concerns are valid, so I will talk to the dialysis team to arrange a meeting with you to further discuss your wishes."
D) "This is an issue that the Ethics Committee will need to evaluate."
Ans: C
Chapter: 44
Cognitive Level: Application
Difficulty: Difficult
Integrated Process: Communication/Documentation
Objective: 5
Patient Needs: C-1
Feedback: The decision to begin dialysis does not require that dialysis be continued indefinitely, and it is not uncommon for patients to consider discontinuing treatment. Patients undergoing dialysis for a while may begin to reevaluate their status, the treatment modality, their satisfaction with life, and the impact of these factors on their families and support systems. Nurses must provide opportunities for these patients to express their feelings and reactions and explore options. These feelings and reactions must be taken seriously, and the patient should have the opportunity to discuss them with the dialysis team. The patient's informed decision about discontinuing treatment, after thoughtful deliberation, should be respected.
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