The nurse is caring for a client with end-stage kidney disease and multiple organ failure. Which action by the nurse indicates an understanding of end-of-life care? Select all that apply.

  • The nurse explains signs and symptoms that indicate death is near.
  • The nurse explains to the client and family what to expect during the final phase of the illness.
  • Cultural beliefs are acknowledged, but priority is placed on life-lengthening treatment options.
  • The nurse avoids talking to the client about impending death to avoid upsetting him and the family.
  • The nurse asks the client and family what their goals and wishes are regarding care, pain management, and emergency resuscitation.
Numbers 1, 2, and 5 are correct.
In providing end-of-life care, the nurse explains to the client and family the signs and symptoms that death is approaching. Explaining what to expect during the final phase of the illness may help alleviate fear and anxiety as the family observes their loved one transitioning through the stages of death. Addressing client and family wishes regarding care, pain management, and emergency resuscitation respects their wishes and ensures that their choices are carried out as much as possible. Cultural beliefs are acknowledged, and life-lengthening treatment options may give way to maintaining comfort. The nurse should not avoid the difficult topic about end-of-life care, but ensure that open discussion is a central part of the client’s care.