Question

Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.

Mr. D Mr. D is a 90-year-old man who was admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction. Mr. D has a long history of comorbidities including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest. Mr. D tells the physician that he wants all measures taken to save his life.

Imagine that you are the nurse assigned to provide care to Mr. D, and address the following:

1. Considering Mr. D's advanced age, what are the benefits/risks associated with providing life-sustaining measures?
2. What factors should you consider based on Mr. D's age and health history?
3. If Mr. D were your family member, how would you respond to his decision?

Answer 1

Physiological changes in cardiovascular system and respiratory system: elderly people tend to have decreased cardiac output and their heart rate and stroke volume has not been improved in the times of stress and has decreased lung capacity and reduction along with stiffness in mobility of the ribs and reduction in   alveolar space and increased anteroposterior diameter. Musculoskeletal system: they prone to get fractures due to loss of bone mass. Gastrointestinal tract: decreased absorption from the medication due to decreased in acids and loss of teeth

1. He is an elderly person aged 90. He has history of diabetes mellitus and hypertension. At present, he has been diagnosed to have myocardial infarction after reading electrocardiogram. He has given willingness to take life sustaining measures in the time of emergency.

a. There is a chance of rib fracture and other fracture while giving CPR

b. Chance of outcome has been decreased with advanced age. Survival rate is 12 percent over the age 90

c. He become responsive to medication which is given during CPR due to slow absorption of medication through the blood as a result of congestive heart failure

d. Tracheal obstruction due to loss of teeth while intubation

e. He has more rigidly of ribs that it makes compression more vulnerable while giving Cardiac pulmonary resuscitation

f. They tend to carotid artery calcification and other arteries duet o diabetes mellitus and aged that impairs blood circulation all over the body and brain

g. Changes in the respiratory system such as decreased alveoli space and lung capacity causes poor respiratory response

h. Increased skin bruises experiences and trauma while providing cardiopulmonary resuscitation

i. Even though he is rescued after giving CPR, there is associated problem occur such as pneumonia infection

j. His neurological system has poor performance because of advanced age.

k. There is chance of injury to internal organs as a result of cardiopulmonary resuscitation.

2. He is hypertensive and diabetic and poor ventricular ejection fraction as he has hypertension, diabetes mellitus and congestive heart failure.

3. After discussing with health care provider about survival rate and benefits. Explain fact regarding benefits and risks with him. If he wants to continue with that, accept his decision. He takes a good decision and he has rights t take health care decisions. Even though there is a chance is 12 % recovery, accept his decision and perform procedure according to his decision. Because he has good spiritual and psychological confidence over the performance of CARDIOPULMONARY RESUSICTATION. Good spiritual and psychological confidence is more than physical health. In the event of crisis, perform the cardiac resuscitation.