The LPN/LVN cares for a client diagnosed with end-stage liver disease. The client has an advanced directive stating that he does not want any blood transfusions. Because the client has severe rectal bleeding, the client's spouse becomes distraught and demands that the client receive blood transfusions. Which of the following actions should the LPN/LVN take NEXT?
1. Notify another family member about the problem.
2. Reassure the spouse that the client will be kept as clean as possible.
3. Inform the spouse that the advanced directive must be honored.
4. Notify the health care provider about the problem.

The correct answer is option (4)

Notify the health care provider about the problem.

Explanation: Family members are more keen/apt to accept decisions if it is communicated by the person with the greatest power; helps them feel everything possible has been done for the client; allowing client to die without initiation of all possible interventions is a welcomed development. Family members sometimes agree to an advanced directive but find it difficult to honour when it appears death is imminent.

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