The nurse is discussing advanced directives with a client who has amyotrophic lateral sclerosis (ALS). The client states, "I do not want to be placed on a mechanical ventilator." How does the nurse respond?
a. "You will need to discuss that with your family and health care provider."
b. "Why are you afraid of being placed on a breathing machine?"
c. "What would you like to be done if you begin to have difficulty breathing?"
d. "You will be on the ventilator only until your muscles get stronger."
C
ALS is an adult-onset upper and lower motor neuron disease, characterized by progressive weakness, muscle wasting, and spasticity, eventually leading to paralysis. Once muscles of breathing are involved, the client must include in the advance directives what is to be done when breathing is no longer possible without intervention. The other statements do not address the client's needs.
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