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Correct Answer: speak to the woman’s health care provider about her wishes.
when a patient in a hospital setting expresses a desire not to be resuscitated in the event they stop breathing, it is critical for healthcare professionals to take appropriate steps to respect and legally document this wish. in the scenario described—a 70-year-old woman in the end stages of terminal stomach cancer stating she does not want resuscitation—the appropriate action is crucial to ensure her wishes are honored.
the first step, as outlined, is for the nurse to communicate with the woman’s healthcare provider about her wishes. this is vital because a do not resuscitate (dnr) order must be formally written and signed by a physician to be legally valid and actionable by hospital staff. the nurse serves as a critical liaison in this process, ensuring that the physician is aware of the patient's wishes so that they can discuss the implications and necessary procedures directly with the patient.
the reason this step is prioritized over others, such as speaking to the next of kin or noting the wishes on the patient's chart without a formal order, is because of the legal and ethical requirements that govern medical care. a dnr order has significant medical, legal, and ethical implications, affecting the type of care the patient will receive in critical situations. it is essential that such orders are clearly understood by both the patient and the healthcare provider and that they are meticulously documented according to legal standards.
furthermore, it is essential for the physician to ensure that the patient fully understands what a dnr order entails. this includes explaining that in the absence of resuscitative efforts, if the patient stops breathing or their heart stops, no attempts will be made to revive them. this discussion also provides an opportunity for the patient to ask questions and express any concerns, ensuring that their decision is informed and considered.
while it may also be appropriate to involve the patient’s next of kin or healthcare surrogate at some point, especially for support or if the patient desires their involvement, this should not supersede the initial and necessary consultation with the healthcare provider. only after a formal dnr order is in place, as per the physician’s authorization and the patient’s informed consent, should further steps be taken to communicate and document this preference across the care team and in the patient's medical records.
in summary, the nurse's initial action to speak with the healthcare provider is not only a procedural necessity but also a safeguard to ensure that the patient's rights and wishes are fully supported and legally recognized within the medical care framework. this step is the foundation for all subsequent actions related to honoring the patient's wishes for end-of-life care.
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