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Question
Mrs. Allie North, an 88-year-old female client, is in the hospice care unit in the hospital. She is mottled from the waist down and her body is cool to touch, and she is complaining she is cold. She has a weak cough and is drooling secretions that tend to pool at the back of her throat and at times she is making gurgling sounds. She is mouth breathing and her lips are dry and cracked. She is drowsy but tries to stay awake to see her large family that keeps coming in to talk to her. They are from out of state and are living at her daughter Karen's house when they are not at the hospital. The nurse notices that Karen is in the same clothes for the past 2 days, and she has not left the bedside of her mother the entire time. The client does not complain of pain, and the nurse notes that she has been receiving the pain medication round-the-clock. She does complain of nausea and refuses to eat or drink stating she just does not feel hungry and the smell of the food makes her stomach turn when her family eats in the room. Her vital signs are T, 96 ° F; BP, 90/50 mm Hg; HR, 90 beats/minute; RR, 16 breaths/minute. The client stated that she wants to see her preacher who has been out of town on vacation and should arrive to see her in another hour because she needs him to pray her over to the other side. The client requests that the nurse contact her old neighbor, Betsy Silas, at 555-5112 to come and see her so she can make amends. She does not want to face God before getting forgiveness from Betsy.
1. What nursing management should the nurse provide in order of importance to meet the client's needs?
2. What nursing management is needed for the family in this situation?
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