The home-care nurse reviews a palliative-care visit. Which findings require immediate follow-up? Highlight the findings that need prompt symptom or safety intervention.
Highlight in Table
Choose your responses, then check the answer.
Explanation
Uncontrolled pain, obstruction-like constipation, severe dyspnea, new agitation, and unsafe crushing of extended-release morphine need prompt intervention. Expected appetite or sleep changes still receive comfort-focused monitoring.
Quick answer Promptly address pain despite rescue doses, five days without stool plus vomiting, breathlessness that interrupts speech, new agitation, and crushed extended-release morphine. These findings show uncontrolled symptoms or an immediate medication-safety hazard.
Why this is correct Palliative care actively treats pain, constipation, nausea, shortness of breath, insomnia, and other distressing symptoms.[1] Opioids can contribute to constipation, and severe abdominal pain or vomiting can signal impaction or obstruction requiring clinical review.[2] New agitation also needs assessment for reversible distress, while extended-release medication must not be altered without verification.
Easy analogy or mental picture Think of comfort care as four volume controls. One controls pain, one breathing, one bowel function, and one alertness. A control stuck at maximum needs prompt adjustment. The picture does not mean every expected end-of-life change should be aggressively treated.
NCLEX decision rule When caring for a palliative client, think comfort plus safety; check whether symptoms are controlled, whether a new change has a reversible cause, and whether medicines are being given as prescribed.
Why the other choices are wrong Smaller preferred meals, dry mouth relieved by ice chips, extra sleep with easy arousal, and continued participation in decisions may fit the client's goals and trajectory. They need ongoing support, but they do not require the same prompt reporting or intervention.
References
[1]
NCI: Palliative Care in CancerNational Cancer Institute
[2]
NCI: Constipation and Cancer TreatmentNational Cancer Institute