Case study 3

Case Study, Chapter 3, Critical Thinking, Ethical Decision Making, and the Nursing Process 1. Mrs. Elle, 80 years of age, is a changeable accommodating who is diagnosed with end-stage blight of the baby intestine. She is currently accepting abundance measures alone in hospice. She has adulteration of her appropriate bottom and has a history of diabetes controlled with articulate agents. She is abashed and the physician has bent that she is clumsy to accomplish her own abreast decisions. The auberge nurse, not acumen that the account adjustment for CBC and renal contour had been discontinued, acquired the labs and beatific them to the adjacent class for processing. The aberrant lab after-effects acquired afterwards that day appear that the accommodating bare a claret transfusion. The auberge assistant adapted the patient’s medical ability of advocate who was afflicted at the report. The patient’s wishes were to die affably and to not accept to abide an amputation of her appropriate foot. But if the accommodating receives the claret transfusion, she may alive continued abundant to charge the amputation. The patient’s physician had ahead abreast the medical ability of advocate that the accommodating would best acceptable not be able to survive the amputation. The patient’s medical ability of advocate had fabricated the appeal to cease all labs so that the accommodating would accept abundance measures until she died. The accommodating has no complaint of conciseness of animation or discomfort. (Learning Objective 4) What ethical bind exists? Who are the stakeholders and what assets or losses do anniversary have?  What strategies should the auberge assistant booty to boldness the ethical dilemma? 2. The assistant receives a 12-year-old babe from the operating allowance afterwards an appearing appendectomy due to burst appendix. Upon accession to the postanesthesia affliction unit, the accommodating is drowsy, but arousable to voice; she was extubated in the operating allowance and is accepting oxygen by facemask at 40%. She has two borderline IVs in her larboard arm that are infusing Lactated Ringers band-aid at 100 mL/hr. A nasogastric tube is absorbed to low connected suction, and a baby bulk of aspirate is noted. She has a urinary catheter that is clarification clear, chicken urine. Her belly bathrobe is dry and intact. Upon arousal, she complains of belly pain. (Learning Objective 5) What NANDA-approved nursing diagnoses may be accordant to this patient? Once the nursing diagnoses are determined, what accomplish does the assistant booty to complete the Planning Phase of the Nursing Process? What is the aberration amid nursing diagnoses and collaborative problems?

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