Woman with moderate dementia and heart failure

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A 90-year-old woman with moderate dementia, heart failure, and chronic renal insufficiency presents with a new onset of weakn marked hyperkalemia with a eGFR=22 mL/min/1.73 m2. Nephrology recommends hemodialysis. When discussing this option wi this treatment. She also inaccurately reports the current year, location, and name of the USA president. When asked why she do states, "I do not want to be on a machine. I am quite old and my health is not good." When asked what she believes will happen she states, "I guess I will die. That is OK." In reflecting on this patient, the NP appreciates that:

Reference no: EM133692512

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