Case Studies In Health Information Management
3rd Edition
ISBN: 9781337676908
Author: SCHNERING
Publisher: Cengage
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You are responding to a private residence for an 80-year-old female, with altered mental status. The husband called 911. When you arrive, their adult son is on the scene. He was not aware of the 911 call and says his dad has dementia and must have gotten scared and called just before he got there. He says his mom is a diabetic and this is a pretty common occurrence, but he's not sure how it happened this time.
The son said her blood sugar was 400, and he was just about to administer her normal dose of insulin. He says that since her sugar is so high, he wants to increase the dose. He is willing to sign a refusal on her behalf.
Do you allow him to give the insulin? Assume the insulin is not expired and is prescribed to her. If yes, do you allow the refusal? Why or why not?
Explain your decision to the son, including what is happening on a physiologic level (in terms a layman can understand)
What is the long-term solution for this situation of repeated episodes of hyperglycemia?
You are the nurse in charge of the Intensive Care Unit, one of the patient's relative ask you if there is a possibility to end the suffering of her brain death patient.
What will be your response?
An elderly man presents himself to the ER. He has contractures and paralysis of his left hand
and is aphasic. Upon questioning, he removes his left shoe and points to his big toe. The nurse
is unable to gather additional information from him because of his difficulty in communicating.
She asks if someone is accompanying him, He shakes his head. The nurse asks him how he
came to the hospital, He shows her a driver's license. Subsequently the nurse leaves the room
and returns a few minutes later to find that the patient has left the hospital having received no
care.
1. What are the ethical implications in this situation?
2. What ethical principles are involved?
3. Should the nurse locate the patient and ensure that be is not endangering himself or
others by driving? Would this be a breach of confidentiality? Autonomy?
4. How does the nurse express fidelity in this situation?
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- An elderly man presents himself to the ER. He has contractures and paralysis of his left hand and is aphasic. Upon questioning, he removes his left shoe and points to his big toe. The nurse is unable to gather additional information from him because of his difficulty in communicating She asks if someone is accompanying him. He shakes his head. The nurse asks him how he came to the hospital. He shows her a driver's license. Subsequently the nurse leaves the room and returns a few minutes later to find that the patient has left the hospital having received no care. QUESTION: What is the beneficent action?arrow_forwardYou are caring for Tim, a 78-y/o man admitted with a neurologic problem. As you enter his room, he says, “Hi, you must be my son’s friend. Come in. I’m Tim & this is my wife, Martha. I’m sorry our house is a mess. This year, 1968, isn’t a good year for us.” 1.How would you describe and document his mental status? 2.What may have contributed to this? Give at least three. 3.From your answer in #2, what will be your 3 topmost priority plans of care? Do not forget to cite your references to support/justify your answers.arrow_forwardAn elderly man presents himself to the ER. He has contractures and paralysis of his let hand and is aphasic. Upon questioning, he removes his left shoe and points to his big toe. The nurse is unable to gather additional information from him because of his difficulty in communicating She asks if someone is accompanying him, He shakes his head. The nurse asks him how he came to the hospital. He shows her a driver's license. Subsequently the nurse leaves the room and returns a few minutes later to find that the patient has left the hospital having received no care. 1. What are the ethical implications in this situation? 2 What ethical principles are involved? 3. Should the nurse locate the patient and ensure that he is not endangering himself or others by driving? Would this be a breach of contidentiality? Autonomy? 4. How does the nurse express fidelity in this situation?arrow_forward
- Dr. Mcgillicuddy increases the dosage of Wilbur’s pain medication, knowing that the risk of death will be increased by that action. Dr. Mcgillicuddy’s intent is not to hasten death, but merely to reduce Wilbur’s pain. This is an example of Choices: physician-assisted death palliative sedation a DNR physician-assisted suicidearrow_forwardit is a clinical case history in which you just need to fill this form. you just need to suppose a patient you are suffering from depression or anxiety and accordingly you have to fill this form and answers must be in detailed) Case History Sheet Personal Information: Client’s name: __ gender: ___ religion/sect: __ Date of birth: __ age: _ marital status: ___, Education: __ Family information: Father’s name: ___ alive: ___ age: __ Mothers name: _____ alive: ____ age: _ Presenting Problems ( Nature Of Problems, Precipitating Event, Patient’s Feelings And Thoughts About Problems) __________________________________________________________ History Of Problems (Duration Of Present Problem, Changes In Nature, And/ Or Frequency Of Problem Over Time, Prodromal Manifestations, Other Past Problems Of A Psychological Nature, No. Of Attacks)______________________________________________ Prior Treatment (Details Of Problems Sought For Presenting Problems And For Whom ; When And For What…arrow_forwardA nurse was aiding with activities of daily living to her client diagnosed with Alzheimer's. The nurse observes the client uses her toothbrush to brush her hair and take notes of the behavior. The client is exhibiting: A. Agnosia B. Aphasia C. Anomia D. Apraxiaarrow_forward
- Why is it important to step out of the pharmacy and interact with other hospital staff.arrow_forwardIn general, how long should pediatricians keep patient records?arrow_forwardMr. Anwari, age 73, is brought to the physician’s office by his daughter, Lucy, who is a licensed practical nurse (LPN). She states her concerns about her father: During the past 2 months he has been found wandering in the neighborhood because he forgets where he lives. Neighbors see him, note that he appears confused, and bring him home. Lucy is worried that her father is showing signs of early Alzheimer’s disease.1. Describe the physical changes that occur in the cortex of the brain.2. Describe the stages of Alzheimer’s disease.3. Describe the physiological and psychological changes that occur during Alzheimer’s dementia.4. What are the functions of the frontal lobe of the cerebral cortex?5. What parts of the limbic system may be affected in Alzheimer’s disease?6. What would be the concerns of the family when a person is diagnosed with this disease?arrow_forward
- Is the prescription is rational or irrational ?arrow_forwardShould a pharmaceutical representative ever take precedence over scheduled patient appointments?arrow_forwardA nurse is caring for a child who is experiencing a generalized tonic/clonic seizure. Which of the following is the priority action for the nurse to take? Position the child in aside- lying position Try to determine the seizure trigger Reorient the child to the environment Place a bite stick in the mouth to prevent injury to oral tissuesarrow_forward
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