A 19-year-old client with a terminal illness has recently changed their code status to DNR. The nurse enters the room and finds the client pulseless. Which of the following actions should the nurse take?

Choice A rationale Chest compressions are the primary component of cardiopulmonary resuscitation used to maintain perfusion during cardiac arrest. However, when a client has a documented Do Not Resuscitate order, performing compressions violates their legal and ethical right to refuse life-prolonging interventions. The nurse must honor the autonomy of the individual, especially when they have made a deliberate choice regarding their end-of-life care after being diagnosed with a terminal illness in a clinical setting. Choice B rationale Rapid response teams are typically summoned when a patient shows signs of clinical deterioration but still has a pulse and is breathing. Their goal is to prevent a full cardiac or respiratory arrest. Since this patient is already pulseless and has a DNR status, calling a rapid response team is inappropriate. The focus of care transitions from rescue to providing a dignified death, making the activation of an emergency response team unnecessary and contrary. Choice C rationale Pressing the Code Blue button initiates a full-scale resuscitation effort involving advanced cardiac life support protocols, intubation, and defibrillation. Initiating a code for a patient with a DNR status is a breach of nursing ethics and legal mandates. The nurse must prioritize the documented wishes of the client over hospital emergency protocols. Resuscitation efforts against a patient's known wishes can result in legal consequences and emotional distress for the grieving family members. Choice D rationale Honoring a DNR order is a fundamental aspect of providing patient-centered care and respecting self-determination. When a terminal patient experiences cardiac arrest, the nurse's role is to provide comfort and support rather than invasive medical intervention. This involves documenting the time of death, notifying the physician, and supporting the family. Refraining from lifesaving measures ensures that the client’s transition is peaceful and consistent with the healthcare goals they established before the event.