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    Case Study, Chapter 3, Critical Thinking, Ethical Decision Making, and The Nursing Process

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    clyde i am
    The hospice nurse obtained labs for an 80-year-old woman with end-stage cancer receiving comfort care, discovering she needed a blood transfusion. However, the woman's power of attorney wanted her to receive only comfort until death and avoid amputation. This created an ethical dilemma around providing the transfusion, as it could prolong the woman's life but require amputation. The document also describes a 22-year-old woman recovering from an appendectomy who is experiencing abdominal pain, to help identify relevant nursing diagnoses and plan care using the nursing process.

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    Case Study, Chapter 3, Critical Thinking, Ethical Decision Making, and The Nursing Process

    Uploaded by

    clyde i am
    274 views2 pages
    The hospice nurse obtained labs for an 80-year-old woman with end-stage cancer receiving comfort care, discovering she needed a blood transfusion. However, the woman's power of attorney wanted her to receive only comfort until death and avoid amputation. This created an ethical dilemma around providing the transfusion, as it could prolong the woman's life but require amputation. The document also describes a 22-year-old woman recovering from an appendectomy who is experiencing abdominal pain, to help identify relevant nursing diagnoses and plan care using the nursing process.

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    The hospice nurse obtained labs for an 80-year-old woman with end-stage cancer receiving comfort care, discovering she needed a blood transfusion. However, the woman's power of attorney wanted her to receive only comfort until death and avoid amputation. This created an ethical dilemma around providing the transfusion, as it could prolong the woman's life but require amputation. The document also describes a 22-year-old woman recovering from an appendectomy who is experiencing abdominal pain, to help identify relevant nursing diagnoses and plan care using the nursing process.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    274 views2 pages

    Case Study, Chapter 3, Critical Thinking, Ethical Decision Making, and The Nursing Process

    Uploaded by

    clyde i am
    The hospice nurse obtained labs for an 80-year-old woman with end-stage cancer receiving comfort care, discovering she needed a blood transfusion. However, the woman's power of attorney wanted her to receive only comfort until death and avoid amputation. This created an ethical dilemma around providing the transfusion, as it could prolong the woman's life but require amputation. The document also describes a 22-year-old woman recovering from an appendectomy who is experiencing abdominal pain, to help identify relevant nursing diagnoses and plan care using the nursing process.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    Case Study, Chapter 3, Critical Thinking, Ethical Decision

    Making, and the Nursing Process

    1. Mrs. Elle, 80 years of age, is a female patient who is diagnosed with end-
    stage cancer of the small intestine. She is currently receiving comfort
    measures only in hospice. She has gangrene on her right foot and has a
    history of diabetes controlled with oral agents. She is confused and the
    physician has determined that she is unable to make her own informed
    decisions. The hospice nurse, not realizing that the weekly prescriptions for
    CBC and renal profile had been discontinued, obtained the labs and sent
    them to the nearby laboratory for processing. The abnormal lab results
    obtained later that day revealed that the patient needed a blood transfusion.
    The hospice nurse updated the patient’s medical power of attorney who was
    distressed at the report. The patient’s wishes were to die peacefully and to
    not have to undergo an amputation of her right foot. But if the patient
    receives the blood transfusion, she may live long enough to need the
    amputation. The patient’s physician had previously informed the medical
    power of attorney that the patient would most likely not be able to survive
    the amputation. The patient’s medical power of attorney had made the
    request to cease all labs so that the patient would receive comfort measures
    until her death. The patient has no complaint of shortness of breath or
    discomfort. (Learning Objectives3 and 4)

    a. What ethical dilemma exists?

    b. Who are the stakeholders and what gains or losses do each have?

    c. What strategies should the hospice nurse take to resolve the ethical
    dilemma?

    2. The nurse receives a 22-year-old women from the operating room after an
    emergent appendectomy due to ruptured appendix. Upon arrival to the
    postanesthesia care unit, the patient is drowsy, but arousable to voice; she
    was extubated in the operating room and is receiving supplemental oxygen
    by facemask. She has two peripheral IVs in her left arm that are infusing
    lactated Ringer solution at 100 mL per hour. A nasogastric tube is attached
    to low constant suction, and a small amount of aspirate is noted. She has a
    urinary catheter that is draining clear, yellow urine. Her abdominal dressing
    is dry and intact. Upon arousal, she complains of abdominal pain. (Learning
    Objective 5)
    a. What NANDA-approved nursing diagnoses may be relevant to this
    patient?

    b. Once the nursing diagnoses are determined, what steps does the
    nurse take to complete the planning phase of the nursing process?

    c. What is the difference between nursing diagnoses and collaborative


    problems?

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