A nurse is caring for a client who has end-stage kidney disease and refuses further hemodialysis treatments. The client has advance directives that indicate no life-sustaining treatments. Which of the following actions should the nurse take?

Rationale: A. Contact the client's family to discuss the decision: While family members may be involved, the nurse must prioritize respecting the client’s autonomy. The client has expressed their wishes, and involving family without consent may violate confidentiality and autonomy. B. Encourage the client to complete a final hemodialysis treatment: Pressuring or encouraging a client to undergo treatment they have refused especially when they have advance directives in place disregards their legal and ethical right to make decisions about their own care. C. Discuss possible options for discharge with the client: Respecting the client’s decision and exploring care planning, such as hospice or palliative care services, is appropriate. This supports autonomy while ensuring comfort and dignity in the end-of-life process. D. Discuss future treatment options with the client's health care surrogate: A surrogate decision-maker is only consulted when the client is unable to make decisions. In this case, the client is alert and capable, so the discussion should remain between the nurse and client.