The nurse admits a terminally ill patient to the hospital. What is the first action that the nurse should complete when planning this patient's care?

• A. Determine the patient's wishes regarding end-of-life care.
• B. Emphasize the importance of addressing any family issues.
• C. Discuss the normal grief process with the patient and family.
• D. Encourage the patient to talk about any fears or unresolved issues.

Answer: (A)

Determining the patient's wishes regarding end-of-life care is the first action because care should be guided directly by the patient’s own values and goals. Establishing these preferences early sets the direction for all subsequent decisions, including what treatments to pursue or withhold, and helps document advance directives or designate a surrogate decision-maker. When the care plan aligns with the patient’s stated goals, the team can choose interventions that respect autonomy and avoid unwanted or non-beneficial measures.

While addressing family issues, normal grief, or fears and unresolved concerns are important, they are best approached after the patient’s preferences are known. Understanding the patient’s goals provides the appropriate context for these conversations and ensures they support, rather than overshadow, the patient’s wishes.