Question

A nurse in a cardiologist office is providing CHF (congestive heart failure) teaching to a newly diagnosed client.  The client asks the nurse should he discuss with his family the topic of advance directives.  

1. What are advance directives?  

2. What are the different types of advance directives?  

3. What is the nurse’s role in advance directives?  

4. Is there a difference between an advance directive and a DNR “do not resuscitate” order?

1. Please explain if YES or NO and why:

Answer 1

No.1.

Advance directives are known as medical directives and advance decisions. It is a type of legal document, in this a person takes advance decisions about his own health care and treatment.

When a person is unable to make a decision due to injury or illness, the advance directive is very useful for making future decisions.In USA like countries advance directive is useful but many countries it is not accepted.

No.2.

The types of Advance directives are:-

1. Living wills - It is a legal document in which a person takes decision for future illnesses. The examples of living will includes administration of Endotracheal tube and feeding tube, use of pain medications, and the decision for resuscitation.

2. Durable power of attorney - It is a legal document in which the patient can give the power to someone else for taking health care decisions for his illness.

No.3.

Nurse’s role in advance directives:-

• When the patient is taking future decisions, the nurse supports the client in decision-making process.
• The nurse needs to inform the patient regarding the advance directives and what possible choices are available.
• The nurse should respect the values of the patient and according to that she should assist the patient during the decision-making process.
• The possible outcomes and technical terms should be described by the nurse which have a great importance in the decision making of the client, and also helps in correct decision making.

No.4

Yes, advance directive and DNR are two different concepts.

DNR “do not resuscitate” order indicates there should be no cardiopulmonary resuscitation given during cardiac arrest.

Advance directive is a prior decision of a client for his future medical care and treatment.

1. The decision of DNR is also a part of the advance directive.

2. The Decision of DNR also can be taken by the family members or doctors.

3. Sometimes some authorities can also take the decision of DNR to save hospital resources.