A multiparous patient at 16 weeks gestation is diagnosed with a fetus likely having anencephaly. The patient plans to continue the pregnancy and donate neonatal organs after death. The nurse should:

• A. Discuss the patient's religious beliefs with the patient.
• B. Avoid discussing organ donation.
• C. Explore the nurse's own feelings about the issues of anencephaly and organ donation.
• D. Advise the patient to terminate.

Answer: (C)

When caring for a pregnant patient facing a fetal anomaly and a desire to donate neonatal organs, the nurse’s first priority is to examine her own beliefs and feelings about anencephaly and organ donation. This self-reflection helps ensure care is nonjudgmental and centered on the patient's values and choices, not the nurse’s personal views. By recognizing any bias, the nurse can support the patient’s autonomy—facilitating informed decision-making about continuing the pregnancy and pursuing organ donation. Discussing the patient’s beliefs and concerns about organ donation can occur, but it should flow from the patient’s needs, not from the nurse’s discomfort or personal stance. It would not be appropriate to avoid the topic, nor to pressure the patient to terminate, as the nurse’s role is to support the patient’s informed, voluntary decision.