Question

A client in the cardiac telemetry unit unexpectedly begins manifesting ventricular fibrillation and the advanced cardiac life support (ACLS) team defibrillates the client, restoring a normal sinus rhythm. Later in the day, a family member question why the code was called, telling the nurse that the client has a living will. How should the nurse respond?

A. Explain that living will cannot be followed by the emergency personnel.
B.Seek clarification of the type of advance directive the client has.
C. Check the client's arm for a "Do Not Resuscitate" (DNR) bracelet.
D. Schedule a client and family conference to review the plan of care.

Answer 1

The nurse should seek clarification of the type of advance directive the patient has. If a DNR order is present and applicable, it must be honored, otherwise, life-saving measures such as defibrillation should be performed during emergencies like ventricular fibrillation.

Step-by-step explanation:

In response to the scenario where a patient with a living will experiences ventricular fibrillation, the nurse should B. Seek clarification of the type of advance directive the client has. Living wills and advance directives express a patient's wishes regarding medical treatment when they are unable to communicate, but these must be clearly understood and applied correctly in medical situations.

In the event of ventricular fibrillation, which is a life-threatening emergency, the immediate goal is to restore normal heart rhythm using defibrillation. A Do Not Resuscitate (DNR) order is specifically for situations where resuscitation is not desired by the patient, but it must be on record and known to medical staff. A discussion with the client and family might be necessary to ensure everyone understands the implications of such directives and the circumstances under which they apply.