When a patient in the terminal stages of lung cancer begins to exhibit loss of consciousness, a major nursing priority is to:
A. Protect the patient from injury.
B. Insert an airway.
C. Elevate the head of the bed.
D. Withdraw all pain medications.
Correct Answer: A. Protect the patient from injury
Ensuring the patient’s safety is the most essential action at this time. This phase is different for each patient, and the needs may differ for each patient and family, but it is vital for healthcare providers to provide care and support in a way that respects the patient’s dignity and autonomous wishes.
Option B: The vast majority of patients who experience a natural death, meaning no medical, life-saving interventions to counter the process, follow a stereotypical pattern of signs and symptoms in the time leading up to death. This time frame is often referred to as “actively dying” or “imminent death.” It is important for healthcare providers to be familiar with this process, not only so they know what to expect when providing direct care to patients during this time, but also so they can guide the family in understanding what to expect during this process and providing support as needed.
Option C: The self-determination of the patient with capacity must be respected. When the patient can make their own choices, their autonomy must be upheld. It is not the role of the provider to impart their values and beliefs onto patients. Patients’ families may experience anticipatory grief and have a hard time fully handling the current situation, and they may want to push their personal choices for the situation instead of respecting their loved one’s wishes and choices.
Option D: The primary goal in treatment for patients is alleviating suffering. Hospice care and palliative care are often confused. Hospice care is the term given to the care provided when a patient is given a prognosis of death within 6 months, and they do not pursue curative treatments. They focus on improving the quality of life which can mean many things. Palliative care can be incorporated into the plan of care at any time for any patient who is experiencing suffering and wants to ease that suffering without directly treating the cause of that suffering.