Question

A nurse is preparing a family for a terminal weaning of a loved one. Which nursing actions would facilitate this process? Select all that apply.

a. Participate in the decision-making process by offering the family information about the advantages and disadvantages of continued ventilatory support.
b. Explain to the family what will happen at each phase of the weaning and offer support.
c. Check the orders for sedation and analgesia, making sure that the anticipated death is comfortable and dignified.
d. Tell the family that death will occur almost immediately after the patient is removed from the ventilator.
e. Tell the family that the decision for terminal weaning of a patient must be made by the primary care provider.
f. Set up mandatory counseling sessions for the patient and family to assist them in making this end-of-life decision.

Answer 1

Preparing a family for the terminal weaning of a loved one includes participating in decision-making, explaining the weaning process, and ensuring orders for comfort care. Appropriate palliative care and emotional support are key to facilitating a dignified end-of-life experience.

Step-by-step explanation:

When preparing a family for the terminal weaning of a loved one from ventilatory support, several nursing actions can facilitate this difficult process. Appropriate options include:

• a. Participating in the decision-making process by offering the family comprehensive information regarding the advantages and disadvantages of continued ventilatory support. This helps in understanding potential outcomes and aligning care with the patient’s preferences and values.
• b. Explaining the weaning process to the family, detailing what to expect at each phase and providing empathetic support. This eases the family’s anxiety and prepares them for the physical changes they might witness.
• c. Checking sedation and analgesia orders to ensure that the patient is comfortable and dignified during the weaning process and subsequent passing. Adequate pain management is central to the provision of humane end-of-life care.

Options such as telling the family that death will occur almost immediately (d), suggesting that only the primary care provider can decide for terminal weaning (e), or setting up mandatory counseling without prior assessment (f) may not be appropriate or helpful, as they can create misunderstandings or take agency away from the patient and family during this sensitive time.