Question

A nurse finds a psychiatric advance directive in the medical record of a patient currently experiencing psychosis. The directive was executed during a period when the patient was stable and competent. The nurse should

a. review the directive with the patient to ensure it is current.
b. ensure that the directive is respected in treatment planning.
c. consider the directive only if there is a cardiac or respiratory arrest.
d. encourage the patient to revise the directive in light of the current health problem.

Answer 1

The nurse should ensure that the psychiatric advance directive found in a patient's medical record is respected in treatment planning. The correct answer is option b.

Step-by-step explanation:

When a nurse finds a psychiatric advance directive in the medical record of a patient experiencing psychosis, which was executed while the patient was stable and competent, the professional and ethical response is to ensure that the directive is respected in treatment planning.

This directive may include important instructions such as a Do Not Resuscitate (DNR) Order or the appointment of a health care proxy. This respect for the patient's prior wishes is crucial, even during periods when the patient is not fully competent, as it reflects their desires regarding their healthcare and treatment.

Reviewing the directive with the patient might not be feasible due to their current state, and encouraging them to revise it during a psychotic episode could be inappropriate and contrary to the purpose of such a directive.