A 40 year old client with mild dementia related to end-stage acquired immunodeficiency
syndrome (AIDS) is preparing for discharge. The client has decided against further curative
treatment. Before discharge, they develop ocular cytomegalovirus (CMV). Their health care
provider recommends treatment with a ganciclovir-impregnated implant, which requires a
surgical procedure. The client’s spouse feels the implant won’t help the client and asks the
nurse if the implant will cure CMV. Which response best answers the spouse’s question while
promoting client advocacy?
“The implant won’t cure the virus, but it may help preserve their vision. If they can’t see you or their surroundings, it may worsen
their dementia and make caring for them at home more difficult.”
“The implant won’t cure the virus. Pll tell the health care provider that you don’t want them to have the procedure.”
“The implant won’t cure the virus in your spouse’s eye. The dementia they have means they are terminally ill. You’re right to refuse
further treatments because nothing more will help them.”
“The implant won’t cure the virus, but it may protect their sight. Just because your spouse has dementia, doesn’t mean they
shouldn’t be given the opportunity to see.”

Question

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In this scenario, the nurse needs to provide a response that is both informative and supportive of the client's and spouse's needs while promoting client advocacy. Let's analyze the options:

1. **"The implant won't cure the virus, but it may help preserve their vision. If they can't see you or their surroundings, it may worsen their dementia and make caring for them at home more difficult."**
   - This response acknowledges the limitations of the treatment while also emphasizing the potential benefits of preserving vision, which can improve the client's quality of life and ease caregiving for the spouse. It promotes client advocacy by considering the client's overall well-being.

2. **"The implant won't cure the virus. I'll tell the health care provider that you don't want them to have the procedure."**
   - This response does not provide enough information about the potential benefits of the implant and may come off as dismissive of the client's needs. It also places the decision solely on the spouse without considering the client's wishes.

3. **"The implant won't cure the virus in your spouse's eye. The dementia they have means they are terminally ill. You're right to refuse further treatments because nothing more will help them."**
   - This response is overly negative and may discourage the spouse. It does not advocate for the client’s potential quality of life improvements and could be seen as a lack of hope.

4. **"The implant won't cure the virus, but it may protect their sight. Just because your spouse has dementia, doesn't mean they shouldn't be given the opportunity to see."**
   - This response is supportive and emphasizes the importance of vision for the client's quality of life, regardless of their dementia. It advocates for the client by recognizing their right to treatment options that may enhance their experience.

Considering the need for client advocacy and the importance of providing a balanced perspective on the treatment options, the best response is:

**"The implant won't cure the virus, but it may help preserve their vision. If they can't see you or their surroundings, it may worsen their dementia and make caring for them at home more difficult."**

This response effectively communicates the limitations of the treatment while also highlighting the potential benefits, thus promoting the client's overall well-being and supporting the spouse's understanding of the situation.
"The implant won't cure the virus, but it may help preserve their vision. If they can't see you or their surroundings, it may worsen their dementia and make caring for them at home more difficult."

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