Question

An older adult male who is in his early 70s is admitted to the emergency department because of a COPD exacerbation. The client is struggling to breathe, and the healthcare team is preparing for endotracheal intubation. The spouse's wife, who is 30 years younger than the client, asks the nurse to stop the procedure and provides the nurse a copy of the clients living will. Which action should the nurse take?

a. Alert the nursing staff of the clients do not resuscitate status
b. Facilitate a family meeting with the palliative care team
c. Place a certified copy of the living will in the client record
d. Notify the healthcare provider of the client wishes

Answer 1

The nurse should notify the healthcare provider of the patient's wishes as stated in the living will, respecting the patient's autonomy and healthcare preferences while adhering to legal and ethical obligations.

Step-by-step explanation:

When the spouse of a patient presents a living will that outlines the patient's wishes regarding medical procedures like endotracheal intubation, it is crucial for the nurse to act in accordance with the patient's directives. In this scenario, the nurse should immediately notify the healthcare provider of the client's wishes as documented in the living will. It is a legal and ethical obligation to respect the patient's autonomy and previously stated healthcare preferences, especially in cases involving end-of-life decisions. The living will legally protects the wishes of the patient when they are unable to communicate and ensures that medical professionals and family members adhere to the patient's desires regarding their care.

In the event of an exacerbation of chronic obstructive pulmonary disease (COPD), where the patient is at a stage of life where they may have decided against invasive life-sustaining measures like intubation, the healthcare providers must weigh the legal documents and the current medical situation. In such cases, the role of the healthcare team is to support the patient and their family by providing comfort and necessary palliative care within the bounds of the patient's expressed wishes.