A nurse is developing a plan of care for a client who has chronic kidney disease. The client gives the nurse copies of their advance directives which state that they do not want to begin dialysis. Which of the following actions should the nurse include in the plan?

Rationale: A. This option is correct because the nurse should document that the client has advance directives in place and specify the treatment preferences, including the refusal of dialysis. Accurate documentation ensures that all members of the healthcare team are aware of the client’s wishes and that care aligns with ethical and legal standards. B. This option is incorrect because a do-not-resuscitate (DNR) order pertains specifically to withholding cardiopulmonary resuscitation in the event of cardiac or respiratory arrest. Advance directives regarding dialysis refusal do not automatically imply a DNR order. C. This option is incorrect because an Against Medical Advice (AMA) form is used when a client chooses to leave the facility against medical advice, not when they are making informed decisions about specific treatments. Refusing dialysis per advance directives is not the same as leaving AMA. D. This option is incorrect because while discussing advance directives with family members can be helpful, the client’s preferences take precedence. The nurse should respect the client’s autonomy and ensure that the plan of care reflects their documented wishes, regardless of family opinion.