# Select all actions appropriate when an ICU client transitions to comfort-focused care.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375162&lang=en  
> language: en  
> subject: Basic Care and Comfort  
> category: BCC

## Question

Select all actions appropriate when an ICU client transitions to comfort-focused care.

1Document the revised goals and stop tests or treatments that do not support comfort.
2Prescribe anticipatory PRN opioid and, when indicated, anxiolytic medication; titrate to symptoms.
3Deactivate ICD shocks and reconsider vasopressors in accordance with the agreed goals of care.
4Support family presence consistent with the client's wishes and offer spiritual-care services.
5Continue routine laboratory draws and escalate vasopressors to normalize every physiologic value.
6Maintain restraints, alarms, and restrictive visitation even when they do not improve comfort or safety.
7Provide mouth care, repositioning, and treatment of dyspnea, pain, anxiety, and noisy secretions.

## Explanation

Comfort-focused care aligns every intervention with relief of suffering and the documented goals of care. Stop burdensome non-comfort tests and treatments; prescribe and titrate opioids for pain or dyspnea and anxiolytics when indicated; deactivate ICD shock therapy; and reconsider vasopressors or other life-prolonging support through the authorized goals-of-care process. Support desired family and spiritual presence and continue mouth care, repositioning, secretion management, and other nursing comfort measures. Routine laboratory testing, escalating vasopressors, restrictive visitation, and non-beneficial monitoring are inconsistent with a comfort-only plan.

## In-depth explanation

Compassionate extubation: pre-medicate, prepare family, then withdraw vent. Document detailed comfort orders with PRN doses.

## Clinical scenario

Multi-organ failure, no recovery expected. Family aligned on comfort.

## Key concepts

- **comfort care** — Care focused on relief of suffering when cure is no longer the goal.
- **ICD deactivation** — Disabling defibrillator shock function while maintaining bradycardia pacing if relevant.
- **death rattle** — Noisy breathing from secretions; managed with positioning and antimuscarinic.

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