What is the first action a nurse should take for a patient with end-stage renal disease who wishes to forgo further treatment?

The first action a nurse should take when a patient with end-stage renal disease expresses a desire to forgo further treatment is to ensure that the patient and their family fully understand the treatment options and the associated risks. This step is critical because informed decision-making is a fundamental aspect of patient autonomy and quality care.

The nurse's role includes providing clear and comprehensive information about what it means to stop treatment, the possible outcomes, and any alternatives available. This approach ensures that the patient’s decision is based on a thorough understanding of their condition rather than misconceptions or incomplete information. Facilitating open discussions allows the patient and their family to ask questions, express concerns, and clarify any uncertainty, thereby supporting their right to make an informed choice regarding their care.

This initial step paves the way for a more in-depth conversation about the patient's values and preferences, fostering a supportive environment for future discussions about end-of-life care and any necessary advance directives.