ethical dilemma exists?
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 of 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 order 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 she died. The patient has no complaint of shortness of breath or discomfort. (Learning Objective 4)
What ethical dilemma exists?
Who are the stakeholders and what gains or losses do each have?
What strategies should the hospice nurse take to resolve the ethical dilemma?
QUESTION 4:
Chapter 4, Health Education and Health Promotion
he community health nurse is planning a health promotion workshop for a high school PTSO (Parent-Teacher-Student Organization). The choice of topics was suggested by the high school’s registered nurse who has observed a gradual increase in student obesity. The two nurses have collaborated to develop this workshop to provide parents, students, and teachers with information about the importance of health promotion. (Learning Objectives 6, 8, and 9)
a. Describe the importance of a focus on health promotion.
b. According to the health promotion model developed by Becker (1993), what four variables influence the selection and use of health promotion behaviors?
c. Describe four components of health promotion.
QUESTION 5: Chapter 5, Adult Health and Nutritional Assessment
The registered nurse prepares to conduct a nutritional assessment on Mrs. Varner, a 52-year-old Caucasian female who describes herself as “overweight most of my adult life.” The client states that her health is good. She works part time as a receptionist and volunteers about 10 hours per week in her church. The nurse obtains Mrs. Varner’s height as 64 inches and her weight as 165 pounds. (Learning Objective 8)
a. What is the rationale for computing body mass index? What is Mrs. Varner’s BMI?
b. Calculate her ideal body weight. What is your assessment of her BMI and weight?
c. Based on Mrs. Varner’s BMI and weight, the nurse measures her waist circumference. Describe the proper procedure for this assessment.
d. Mrs. Varner’s waist circumference is 38 inches. What is your assessment?
e. What laboratory values would the nurse review to evaluate Mrs. Varner’s protein levels?
QUESTION 6: Chapter 6, Individual and Family Homeostasis, Stress, and Adaptation
Mary Turner stepped on a nail 5 days ago and sustained a puncture about 1 inch deep. She immediately cleaned the area with soap and water and hydrogen peroxide, and applied triple antibiotic ointment to the site. Today she comes to the clinic with complaints of increased pain and swelling in her foot. On assessment, the nurse notes that the puncture site is red and edematous, and has a moderate amount of yellowish drainage. (Learning Objective 9)
a. Describe the sequence of events that caused the local inflammation seen in Mary’s foot.
b. What is the role of histamine and kinins in the inflammatory process?
c. Which of the five cardinal signs of inflammation does Mary exhibit?
d. Because Mary’s injury occurred 5 days ago, the nurse should assess for what systemic effects?
QUESTION 7:
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