HESI Case Study: Loss, Grief and Death| Questions and Answers(A+ Solution guide)

A pt who is elderly suffered a stroke a year ago remains weak, has R-sided paralysis and dysphagia. Her spouse has been caring for her at home. A home health RN visits every other day and the community has been providing one meal a day. The pt's adult child lives several states away. The pt was sitting upright while her spouse fed her broth from chicken noodle soup. She started coughing and spitting out the broth, then becomes SOB. The spouse stopped feeding her and patted her back forcefully. The pt was able to catch her breath. 2 days later during a scheduled visit, the spouse informs the home health RN about the incident. The RN assessment reveals the pt's LOC has declined, she has an oral temp 102 F (38.9 C) and diminished breath sounds with crackles in the R lung. The home health RN reports the assessment findings to the HCP. The HCP admits the pt to an acute care facility with the diagnosis of aspiration pneumonia. Which assessment should the RN complete immediately after hearing the pt choked while eating? a. The caregiver's knowledge about feeding a person who is dysphagic b. Auscultate the pt's lungs for adventitious breath sounds c. Assess the pt's LOC with the mini-mental status exam d. Determine the pt's ability to swallow liquids - Auscultate the pt's lungs for adventitious breath sounds The RN assessment reveals the pt's diminished breath sounds with crackles in the R lung, her LOC has declined, and she has an oral temp 102 F (38.9 C). After the pt assessment is complete, what does the RN determine is the BEST course of action? a. Report the assessment findings to the HCP b. Elevate the head of the pt's bed to 45 degrees and instruct the spouse to leave it elevated c. Inform the spouse to give the pt acetaminophen d. Provide directions on how to properly feed a person with dysphagia to the spouse - Report the assessment findings to the HCPThe HCP orders the pt be admitted to the hospital. They also order a CMP, CBC, swallow eval, and saline lock. During the admission procedure, what is the RN's responsibility regarding advance directives? a. Determine if the pt has completed a Living Will and a durable power of attorney for healthcare (DPAHC) b. Explain that the Pt Self-Determination Act (PSDA) requires a living will. c. Instruct the pt's spouse to have the pt sign a Living Will when she's no longer disoriented d. Ask the pt's spouse if they would like to make any changes - Determine if the pt has completed a Living Will and a durable power of attorney for healthcare (DPAHC)