A nurse is developing a care plan for a terminally ill patient who has transitioned to palliative care. What is the primary goal that should guide the care plan?

Appeared in: HPSSC - 2015

Explanation

The primary goal of palliative care is to improve the quality of life for patients and their families by addressing the multifaceted aspects of suffering.
This is achieved through a holistic approach that focuses on preventing and relieving physical, psychosocial, and spiritual problems.
Care shifts from aggressive, curative treatments to managing symptoms and providing comfort, ensuring the patient's dignity is preserved.
Palliative care is appropriate at any age and any stage of a serious illness and can be provided along with curative treatment.

Option A: This describes the goal of curative care, which aims to cure a disease or prolong life. Palliative care's primary focus is on quality of life and symptom relief, not aggressive treatment.
Option C: Patient autonomy is a cornerstone of ethical medical care. The patient's wishes are paramount in decision-making. While the family is considered the unit of care and their input is valued, they do not have the authority to make all final decisions against a capable patient's will.
Option D: Limiting communication is counterproductive and can worsen emotional distress. Palliative care emphasizes open, honest, and therapeutic communication to help patients and families process emotions, address fears, and make informed decisions.

Clinical Relevance

Nursing practice connection: Use the key finding related to Primary Goal of Palliative Care to guide bedside assessment, documentation, and the next nursing action.
Nurses play a vital role in advocating for patients' palliative needs, ensuring their pain is managed, their dignity is respected, and their end-of-life wishes are honored.
Effective palliative care requires a collaborative interdisciplinary team, including physicians, nurses, social workers, and spiritual advisors, to provide holistic support.
What if the patient is non-verbal and has no advance directive? The care team, in collaboration with the family, would focus on the principle of 'best interest,' using non-verbal cues (like grimacing) and physiological signs to assess comfort and guide symptom management, while trying to honor what is known about the patient's values.

How to Approach the Question

First, identify the core concept of the question, which is 'palliative care'.
Recall the fundamental definition and goal of palliative care: it is about improving quality of life, not curing disease.
Evaluate each option against this core principle.
Option A (aggressive treatment) is the opposite of palliative care's focus, so it can be eliminated.
Option C (family makes all decisions) violates the principle of patient autonomy, a key ethical consideration.
Option D (limit communication) contradicts the need for therapeutic support in palliative care.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 4 pp. 47-49, 44-46

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 92-94

Practise the full HPSSC - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.