Reference no: EM133377637
Case Study: In this unfolding case study that simulates the complexities of clinical practice, you will assume the role of a nurse in the critical care setting. You will use a holistic approach to provide safe care by making correct clinical judgments for patients with a left middle cerebral artery (MCA) ischemic stroke, renal failure, rhabdomyolysis, chronic obstructive pulmonary disease (COPD), and atrial fibrillation.
Present Problem
Hamari Sato is a 58-year-old woman with a history of atrial fibrillation, COPD, and depression. A friend who had not heard from her for two days became concerned and went to her home. She found Hamari unresponsive on the floor of her living room.
She had a large left middle cerebral artery (MCA) ischemic stroke. She is intubated and has remained in ICU since admission to the hospital five days ago. She is also in acute renal failure due to rhabdomyolysis and requires daily dialysis.
Personal/Social History
Hamari is a widow and has one adult daughter. She and her husband moved to the US when she was 20 because of her husband's work. Although she graduated from high school in Japan, she has never worked outside of her home in the US. Her siblings
live in Japan, and she has not talked to her daughter in three years. She is on disability for severe depression and inconsistently takes her scheduled medications, including citalopram and warfarin, depending on how she feels.
Questions:
1.) Which findings are most important and noticed by the nurse as clinically significant?
2.) What additional information is needed by the nurse to clarify and identify the current practice dilemma?
3.) What aspects of the American Nurses Association (ANA) Code of Ethics can the nurse use to clarify how to best respond to this dilemma?
4.) What additional healthcare team members are needed to collaborate with the nurse to resolve this dilemma?
5.) What nursing priority will guide how the nurse responds to resolve this dilemma? List three priority interventions and the expected outcome.
6.) Does this dilemma warrant a review by the hospital's medical ethics committee? Why or why not?
7.) Write a concise nurse's note to document what was most important in the medical record at the end of your shift.