A resident with an advanced directive (living will) states they do not wish to be fed by artificial means if they become unable to swallow. The nurse aide finds the resident unresponsive and unable to take food orally. What should the nurse aide do?
- AImmediately insert a feeding tube, as the resident is at risk of dehydration.
- BOffer the resident sips of water to keep them hydrated.
- CAttempt to gently spoon-feed the resident small amounts of pureed food.
- DNotify the nurse immediately and review the resident's advanced directive.
Show answer & explanationAnswer & explanation
Correct answer: D. Notify the nurse immediately and review the resident's advanced directive.
An advanced directive (living will) specifies a resident's wishes regarding medical treatment, including artificial feeding. Upon discovering a change in condition that relates to the directive, the nurse aide's immediate responsibility is to notify the nurse, who will then review the directive and make decisions consistent with the resident's stated wishes.
Why the other options are wrong
- A. Inserting a feeding tube is a medical procedure outside the CNA's scope of practice and potentially against the resident's wishes.
- B. Offering sips of water to an unresponsive resident is an aspiration risk and may go against the advanced directive's intent regarding artificial hydration.
- C. Attempting to feed an unresponsive resident is dangerous due to aspiration risk and goes against the advanced directive.
Advanced Directives and CNA Role
An advanced directive (e.g., living will, durable power of attorney for healthcare) is a legal document outlining a person's wishes regarding future medical care. CNAs must be aware of these and report changes in condition to the nurse, who will ensure the directive is followed.
- Advanced directives guide future medical decisions.
- CNAs do not interpret or act on directives directly.
- Always report relevant changes to the nurse.
Memory trick: Directive change? Notify the nurse, don't deviate.