Case Study, Chapter 3, Critical Thinking. Ethical Decision Making, and the Nursi

Question

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 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 arn 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) a. What ethical dilemma exists? b. Who are the stakeholders and what gains or losses do each have? What strategies should the hospice nurse take to resolve the ethical dilemma? C.

Explanation / Answer

Ethical dilemma occurs when there is a conflict between two or more ethical principles

There is no no correct decision exist and nurse must make a choice between two alternatives but both are not satisfactory

There is many conflict amputation of limb required consent but patient is confused ,patient is on end stage intestinal cancer receive treatment ,patient want to die peacefully but if blood is transfused and amputation done then patient can live more

Medical atorny have right to decide what should order for lab test and transfusion

There is patient have the right refuse sign the consent or not for treatment and comfort measure

There is patient and medical atorny are stakeholder.nurse should follow ehics of nursing she is advocate of patient have the right to ask the physician about blood transfusion and regular blood investigations

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