[Answered]: A nurse is caring for a client who has terminal…

A nurse is caring for a client who has terminal colon cancer. Exhibit 1 Exhibit 2 Exhibit 3 Exhibit 4 Nurses’ Notes 1345: Client’s skin is warm and dry. Mucous membranes are moist and pink. Awake, alert, and oriented to person, place, and time. Heart sounds regular. Lung sounds clear. Respirations – regular and unlabored. Bowel sounds hypoactive all four quadrants. 3+ non-pitting edema noted to lower extremities bilaterally. Gait unsteady. Generalized weakness reported. Reports abdominal pain, primarily in the right lower quadrant, as 5 on a scale of 0 to 10. 1820: Client demonstrates guarding of right lower quadrant of the abdomen and reports pain as 7 on a scale of 0 to 10. Vomited 250cc green emesis. Vital Signs 1345: Blood pressure (BP) 158/94 mm Hg Respiratory rate 20/min Heart rate 94/min Temperature 37.6° C (99.7° F) Oxygen saturation (Sa02) 96% on room air 1820: Blood pressure (BP) 160/94 mm Hg Respiratory rate 20/min Heart rate 92/min Temperature 37.1° C (98.8° F) Oxygen saturation (Sa02) 97% on room air Plan of Care Client with stage 4 colon cancer. Potential metastasis to liver noted. Scans pending. Prognosis is poor with death likely within six months. Per discussion with client and family, will discontinue chemotherapy and radiation treatments. Client and family have requested a DNR order. Will plan meeting with the family to discuss terminal care expectations. Provider Prescriptions Do not resuscitate For each of the following, click to specify whether the prescription is anticipated, nonessential or contraindicated for the client. Assessment Findings Anticipated Nonessential Contraindicated Schedule consult with social services and spiritual advisor Oxygen 7L/min per face mask Morphine (Duramorph) 5 mg orally every 4 hours as needed for pain Albuterol (Ventoline) 1.25mg/3 mL per nebulizer treatment every four hours prn Do not intubate Hospice care