Question

The graduate licensed practical nurse is assigned to care for the client on ventilator support, pending organ donation. Which goal should receive priority? A. Maintain the client's systolic blood pressure at \(70 \mathrm{mmHg}\) or greater B. Maintain the client's urinary output greater than \(300 \mathrm{cc}\) per hour C. Maintain the client's body temperature of greater than \(33^{\circ} \mathrm{F}\) rectal D. Maintain the client's hematocrit less than \(30 \%\)

Short answer

Answer: Option A) maintaining systolic blood pressure at \(70 \mathrm{mmHg}\) or greater.

Step-by-step solution

Analyze each option

In order to select the priority goal for the client, we need to evaluate each option one by one, considering their relevance to organ donation. Option A: Maintaining the client's systolic blood pressure is crucial for maintaining organ perfusion, which is essential to maintain viable organs for transplantation. Option B: Maintaining the client's urinary output is important for monitoring kidney function and providing an indication of other potential organ issues. Option C: Ensuring the client's body temperature is adequately maintained is necessary for general patient care; however, it might not be directly related to the viability of organs for transplantation. Option D: Maintaining the client's hematocrit level has an influence on oxygen-carrying capacity in the blood. A low level can negatively impact organ function.

Identify the priority goal

Considering the significance of each option in the context of organ donation, the priority goal should be the one that has the most direct impact on maintaining organ viability. In this case, the priority should be maintaining proper organ perfusion.

Choose the correct answer

Based on the analysis, the priority goal should be to maintain the client's systolic blood pressure at \(70 \mathrm{mmHg}\) or greater (Option A). This is essential for providing adequate organ perfusion and ensuring that organs remain viable for transplantation.

Key concepts

Organ Donation Care

Organ donation is a process that involves the removal of organs or tissues from a donor, either living or deceased, with the aim of transplanting them into other individuals in need.
The primary goal of organ donation care is to ensure that the organs remain viable for transplantation. This involves careful management of the donor's bodily functions to keep the organs healthy and suitable for recipients.
When a patient is on ventilator support and is a potential organ donor, healthcare providers focus on maintaining:

• Stable blood circulation to preserve organ perfusion.
• Adequate oxygenation to prevent tissue damage.
• Normal body temperature and other vitals to avoid organ deterioration.

In scenarios where a patient is being prepared for organ donation, it is critical to prioritize goals that directly affect organ preservation. Ensuring the donor's blood pressure is sufficient (such as maintaining systolic blood pressure) helps maintain effective circulation, thereby keeping organs healthy for future recipients.

Ventilator Support Management

Ventilator support management is an integral part of caring for patients who cannot breathe on their own.
Patients on ventilators require constant monitoring to ensure that they receive the appropriate oxygen levels and ventilation needed for their condition.
Key aspects of this management include:

• Regular adjustment of ventilator settings to meet the patient's respiratory needs.
• Monitoring of blood gas levels to check oxygen and carbon dioxide levels.
• Routine checks for any mechanical ventilator issues.
• Preventing complications such as pneumonia or lung damage.

Particularly in organ donation scenarios, ventilator support is vital for maintaining organ function. By ensuring that oxygen delivery remains consistent and adequate, the organs can remain viable while waiting for transplantation.

Critical Thinking in Nursing

Critical thinking in nursing is an essential skill that involves analyzing and evaluating information to make sound clinical decisions.
Nurses employ critical thinking to prioritize patient care, especially in complex situations like organ donation or managing ventilator support.
Some aspects of critical thinking in nursing include:

• Assessment and interpretation of patient data to determine needs.
• Anticipating and identifying potential complications.
• Deciding on the best interventions based on clinical evidence.
• Reflecting on patient outcomes to refine future decision-making processes.

By using critical thinking, nurses can respond quickly and effectively to changes in a patient's condition, ensuring that the care provided is both proactive and appropriate. This is particularly important in high-stakes situations like maintaining organ viability for donation.