medium · NCLEX-RN Basic Care and Comfort
A 68-year-old client with end-stage renal disease has transitioned to comfort care in a hospice facility. The client is unresponsive, positioned in a semi-Fowler's position, and has loud, wet, gurgling respirations. The client's caregiver is highly distressed, crying, and asks the nurse, 'Please, can't you do something to stop that horrible choking sound?' Which action should the nurse take first?
- Explain to the caregiver that this is a normal part of dying and that no active clinical interventions are required.
- Turn the client to a lateral side-lying position and administer ordered sublingual atropine drops.
- Vigorously suction the client’s mouth, pharynx, and upper trachea to physically remove the secretions.
- Request an order to insert an oral pharyngeal airway to keep the tongue from obstructing the airway.
Sign up free to see the explanation and track your rank →
More NCLEX-RN Basic Care and Comfort practice
- Which finding most likely indicates that the client is successfully compensating for the f
- Which laboratory finding would the nurse most likely anticipate as a consequence of this e
- Which statement by the client indicates a correct understanding of the instructions?
- Which action is the priority to include in the plan of care?
- A nurse is assessing a client for urinary retention. Which finding would provide the most
- Which task can the nurse safely delegate to an LPN/VN?
- What should the nurse perform next?
- The nurse is caring for a client with acute lower back pain. Which findings should the nur