Question

In: Nursing

Patient has Stevens-Johnson syndrome with uncertain prognosis (50/50 chance). Patient arrests, is unconscious vented and needs...

Patient has Stevens-Johnson syndrome with uncertain prognosis (50/50 chance). Patient arrests, is unconscious vented and needs dopamine to maintain her blood pressure constantly. Patient disclosed to family and nurse prior to arrest that she does not wish to be kept alive should she become a "vegetable". She also has an advanced care directive stating that should she become terminal, she does not wish for life sustaining measures. Nurse says to doctor that perhaps we should discontinue treatment in accordance with patient and family wishes. Doctor says no. nurse hangs a bag of normal saline, labels it dopamine, patient arrests and dies. Was this ethical?

1. Discuss any Federal &/or State laws (California) that apply?

Expert Solution

Yes it is ethical, if patient or patient relatives does not wish for life sustaining measures.

1.Discuss any Federal &/or State laws (California) that apply?

There are many advance directive formats. Some follow forms outlined in state laws, others are created by lawyers or even the patients themselves. All states and the District of California have laws about advance directives. Be sure to know specific requirements of writing legal advance directives in health care system.

The most common types of advance directives are

▪ The living will

▪ The durable power of attorney for health care

▪ Do not Resuscitate (DNR) orders

▪ POLST (Physician Orders for Life-Sustaining Treatment

The living will

The living will is a legal document used for future health care decisions only when a person becomes unable to make the decisions and choices on their own. The living will is only used at the end of life if a person is terminally ill (can't be cured) or permanently unconscious. The living will describes the type of medical treatment the person would want or not want to receive in these situations.

Living will laws vary from state to state. Be sure to know your specific state laws.

Durable power of attorney for health care/Medical power of attorney

A durable power of attorney for health care, also known as a medical power of attorney, is a legal document where patient name a person to be a proxy (agent) to make all his/her health care decisions if become unable to do so.

If regain the ability to make his /her own medical decisions, proxy (agent) can't continue to make medical decisions on behalf.

Do_not _Resuscitate

A Do Not Resuscitate or DNR order means that if stop breathing or heart stops, nothing will be done to try to keep alive. If he /she is in the hospital, relative can ask doctor to add a DNR order to medical record.

POLST (Physician Orders for Life-Sustaining Treatment)

A POLST form also helps express patient wishes for health care, but it is not an advance directive. A POLST form has a set of specific medical orders that a seriously ill person can fill in and ask their health care provider to sign. A POLST form addresses patient wishes in an emergency, such as whether to use CPR (cardiopulmonary resuscitation) in an emergency, or whether to go to a hospital in an emergency and be put on a breathing machine if necessary, or stay where you are and be made comfortable.

Many individuals at the end of life are unable to convey their wishes regarding medical treatments. Advance directives (ADs) allow them to crystallise their wishes in a written form so that these can be carried out if the relevant situation arises.

Nightingale answered 2 years ago

a patient needs IV heparin, which has a concentration of 50 units/mL. The patient needs to...

a patient needs IV heparin, which has a concentration of 50 units/mL. The patient needs to be dosed with 250 units over 5 hours. What is the flow rate necessary for administration of the drug? Flow rate (mL/Hour)_______

1. A firm's stock has 50% chance of a 13% rate of return and a 50% chance...

1. A firm's stock has 50% chance of a 13% rate of return and a 50% chance of a 20% rate of return. What is the standard deviation of return for this stock? Answer as a percent return to the nearest hundredth of a percent as in xx.xx without entering a percent symbol. 2. A firm's stock has 50% chance of a 35% rate of return. a 30% chance of a 18% rate of return. and a 20% chance of a -24%...

Aaron is a farmer and faces the following uncertain situation. He has a 20% chance of...

Aaron is a farmer and faces the following uncertain situation. He has a 20% chance of having a poor harvest where he will lose $ 5000 and an 80% chance of having a good harvest where he will gain $ 10,000. Aaron has a current wealth of $ 80,000 and a utility function of the form U(W) = ln W. What is the expected value of his final wealth in this situation? What is the expected utility of this uncertain...

Stock has a 25% chance of producing a 36% return, a 50% chance of producing a...

Stock has a 25% chance of producing a 36% return, a 50% chance of producing a 12% return, and a 25% chance of producing a -18% return. What is the firm's standard deviation? Do not round your intermediate calculations.

Your investment has a 20% chance of earning a 26% rate of return, a 50% chance...

Your investment has a 20% chance of earning a 26% rate of return, a 50% chance of earning a 15% rate of return and a 30% chance of losing 9%. What is your expected return on this investment? Enter answer in percents, accurate to two decimal places.

If a patient has a disease there is a 93.8% chance that the test gives a...

If a patient has a disease there is a 93.8% chance that the test gives a correct positive response and if a patient does not have this disease, there is a 95.6% chance that the test gives a correct negative response. About 20 out of every 1000 members have the disease. i) A member has the disease given that they have a positive test response ii) A member has the disease given that they have a negative test response

Dothan Inc.'s stock has a 25% chance of producing a 16% return, a 50% chance of...

Dothan Inc.'s stock has a 25% chance of producing a 16% return, a 50% chance of producing a 12% return, and a 25% chance of producing a -18% return. What is the firm's expected rate of return? Do not round your intermediate calculations. a. 4.51% b. 4.29% c. 5.50% d. 4.68% e. 6.38%

Taggart Inc.'s stock has a 50% chance of producing a 25% return, a 30% chance of...

Taggart Inc.'s stock has a 50% chance of producing a 25% return, a 30% chance of producing a 10% return, and a 20% chance of producing a −28% return. a. What is their expected rate of return? b. What is their standard deviation of returns? c. What is their coefficient of variation?

A) Lance the Wizard has been informed that tomorrow there will be a 50% chance of...

A) Lance the Wizard has been informed that tomorrow there will be a 50% chance of encountering the evil Myrmidons and a 30% chance of meeting up with the dreadful Balrog. Moreover, Hugo the Elf has predicted that there is a 10% chance of encountering both tomorrow. What is the probability that Lance will be lucky tomorrow and encounter neither the Myrmidons nor the Balrog? B)The astrology software package, Turbo Kismet,† works by first generating random number sequences and then...

The patient is a 48-year-old unconscious woman admitted to the ED. She has a known history...

The patient is a 48-year-old unconscious woman admitted to the ED. She has a known history of type 1 diabetes mellitus. Her daughter accompanies her and tells the staff that her mother has had the “flu” and has been unable to eat or drink very much. The daughter is uncertain whether her mother has taken her insulin in the past 24 hours. The patient’s vital signs are temperature 101.8° F; pulse 120, weak and irregular; respiration 22, deep, and fruity...