hard · NCLEX-RN Management of Care
The nurse participates in the care of a client undergoing neurologic determination of death and potential organ procurement. Arrange the clinical actions in the correct chronological and legal order. Base the response on this specific EHR: "history_and_physical": "client": "Sarah, age 34", "setting": "Intensive Care Unit (ICU)", "diagnoses": "Catastrophic closed head injury following an industrial accident; severe diffuse cerebral edema and bilateral ton.
- Implement specialized donor-management protocols (e.g., maintaining target hormone replacement, MAP, and electrolyte balance) to preserve transplantable organ perfusion.
- Verify that clinical treatment goals and discussions of brain death are kept strictly separate from the organ donation request to maintain ethical boundaries.
- Participate in a joint meeting with the OPO representative and the family, ensuring the family understands that neurologic death has occurred before the OPO representative discusses donation options.
- Coordinate the client's transport to the operating room for organ recovery, followed by standard post-mortem care and administrative documentation.
- Assist the provider with the formal clinical exams for neurologic determination of death (e.g., brainstem reflex testing and apnea testing) while maintaining precise hemodynamic support.
- Initiate a timely referral to the local Organ Procurement Organization (OPO) when the hospital-OPO agreement's clinical triggers are met, before any donation request occurs.
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