Question

An 80-year-old client has an advance directive that states "do not keep alive by any heroic means." The client suffered a heart attack, and the family is requesting full code. Which nursing action taken by the nurse is correct?

Initiate only cardiopulmonary resuscitation (CPR). Call a code and resuscitate the client as requested by the family. Transfer the client to the intensive care unit for ventilator support. Use only pain medication to keep the client comfortable.

Answer 1

The correct nursing action, when an elderly client has an advance directive stating no heroic measures should be taken, is to provide comfort care with pain medication, not CPR or other resuscitative measures. The nurse should adhere to the patient's advance directive, even if the family requests a full code.

Step-by-step explanation:

When an 80-year-old client with an advance directive that states "do not keep alive by any heroic means" suffers a heart attack, the correct nursing action aligns with the patient's wishes expressed in their advance directive. Given that the client has specified not to be kept alive by heroic measures, the advance directive functions similarly to a Do Not Resuscitate (DNR) order. In this scenario, if the family requests a full code contrary to the advance directive, the nurse should consult with the healthcare team to address the discrepancy between the family's wishes and the patient's documented directive. The appropriate action would typically involve using only pain medication to keep the client comfortable, rather than initiating CPR or other resuscitative measures that would go against the client's explicit wishes. This respects the client's autonomy and adherence to legal and ethical directives within medical care.