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Name five ethical principals.
Jack, a 16 year-old boy is diagnosed with X. There are two choices of treatment. The teenager favors a different course of action than the parents. The nurse's belief is that Jack should have the final word on choice of treatment. In this case which ethical principle stands out?
A patient is in danger of losing their right leg. A choice must be made between two procedures. The first is relatively painless and recovery will be fast, but, has a small chance of success. The other option has a far greater chance of success, but, the procedure is lengthy, painful, and has a long recovery period. Which two ethical principles need to be addressed with this case?
Beneficence and nonmaleficence
Martha, a terminally ill patient has decided to get a DNR. The assigned nurse, Zelda, believes that, though there would be pain, proper care would allow the patient to live for another year. The nurse after receiving report, learns that Martha is likely to die that evening. Wanting nothing to do with her patient's death, the Zelda, leaves the unit. What, if any, legal issues, may the nurse be held accountable to.
Leaving a patient after accepting assignment is abandonment. If the nurse had instead refused assignment they could have been considered insubordinate.
Frances, a seventeen year-old, who is deaf, is told by her health-care provider that she is a candidate for a new procedure that allow her to hear. Frances is married and together they have a one year-old child. Both the husband and the young woman's parents are enthusiastically in favor of the procedure, whereas Frances is uncertain. Can she, being a minor, go against her husband and parent's wishes and not have her hearing restored? Why?
Yes, she can, even though she is a minor, the fact that she is married, means that she is an emancipated minor and can give legal consent regarding her treatment. (Potter and Perry, 333)
Name at least two circumstances under which a minor may give legal consent for medical treatment.
- Legally married.
- A parent,
- For their own child.
- Venereal disease
- Pregnancy (abortions excluded)
- Drug or substance abuse
What nursing interventions may be used to prevent orthostatic hypotension?
- Mobilize client as soon as physical condition allows:
- --- Dangle
- --- OOB to chair
- --- Ambulate
- Move the client gradually during position changes.
- Monitor for dizziness while assessing orthostatic blood pressures.
Massaging a leg with DVT is just one choice that may be used as a nursing intervention. True or False? Why, why not?
False! Massaging the limb has the risk of dislodging the thrombi allowing it to travel to other parts of the body.
Jackie, is setting up a sterile field. While opening a sterile dressing, she discovers that the gloves prevented her from noticing that the packaging is wet, fortunately, it doesn't look like the dressing itself is wet. What must she do?
In this case the dressing cannot be used, since, anything that is wet is considered contaminated. The items in the wet package are also now contaminated. Jackie's gloves which came in contact with the wet package are also contaminated.
A patient, Robert, with rubella has been admitted to your floor. Answer these three questions:
Is this defined as a Tier One or Tier Two infection?
What category does it fall under?
What PPE must be used when entering Robert's room?
- Rubella is considered a Tier Two infection.
- Rubella falls within the category of requiring droplet precautions.
- A mask or respirator is required PPE for rubella.
- (Potter and Perry, 663-64)
When does a nurse document giving meds to a patient?
A. After they are prepared.
B. After they are given.
C. Before they are prepared and given.
D. At patient discharge.
B. After they are given.
(this multiple choice question has been scrambled)
When and how frequently must a STAT order be administered?
A medication with a STAT order must be administered within 5 minutes or less and is given only once.
Frank is a 60 year-old white male. He complains of stomach pain and vomiting. He voices his concern saying, "The pain starts soon after I eat so I've started to avoiding eating." and he adds, "At least it doen't bother me at night and I can get some rest." This sounds like a case of PUD, but, where is it likely to be located.
- The symptoms given indicate a gastric ulcer.
- -- Pain starts 1/2 to 1 hr after a meal.
- -- Pain is not relieved by eating.
- -- Pain at night is rare.
- -- Vomiting
Under what conditions would a patient with a duodenal ulcer who has been ordered a PPI also be prescribed an antibiotic?
In many cases Helicobacter pylori are implicated along with PUD. Often a triple therapy is ordered, two of which are antibiotics.