hard · NCLEX-RN Management of Care

The intensive care unit nurse is caring for a client undergoing Donation after Circulatory Death (DCD). The family has withdrawn mechanical ventilation, and the client is receiving comfort-directed palliative care in the operating room. Two hours have passed since extubation, and the client continues to maintain a stable respiratory rate and heart rate with a systolic blood pressure of 85 mm Hg.

Which action is the nurse's priority?

  1. Request a prescription for a lethal dose of intravenous morphine to hasten cardiac arrest before the warm ischemia window closes.
  2. Coordinate the transfer of the client back to a palliative care or medical-surgical unit to continue comfort-focused end-of-life care.
  3. Instruct the surgical team to remain in the operating room and keep the client on the procedural table indefinitely.
  4. Prepare to re-intubate the client and re-initiate vasopressor infusions to stabilize physiology for a future attempt, for this client.

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