You work as an RPN at a major metropolitan hospital on a medical unit.

Mr. Cote has end-stage Alzheimer’s Disease. He has had a stroke and is hospitalized in your unit. He can no longer swallow. Before the stroke, Mr. Cote did have some brief moments where he was lucid and able to converse. After his stroke, he deteriorated very quickly and no longer has any moments where he is lucid or can make any decisions.  His physical health has deteriorated and the healthcare team estimates that with a feeding tube, he may live another 2 to 6 months.

In the past month, Mr. Cote has pulled out his feeding tube twice. Now he needs to have his arms restrained to stop him from pulling out the tube. The healthcare team wants to stop all feeding and intravenous therapy and let Mr. Cote die.

His wife insists that he have a feeding tube. She says that if he does not have the feeding tube, she will be responsible for ending his life. She adds that if the team does not re-insert the tube when he pulls it out they will be responsible for his death.

Mrs. Cote says her husband does not know what he is doing and the tube must remain.

You are in a team meeting to discuss what to do next and your manager says to you. “You took a class that discussed ethics. What do you think is the right thing to do in this case?” Question:

 What is the ethical dilemma? State specifically what the issue here is.  What is the actual ethical dilemma the persons (nurse, client, Dr. etc) are facing in your scenario?

Identify the ethical principle and explain why?

 

What are the roles? Who was involved?who is responsible to make the decision? And who is affected by the decision, and why they are affected by the decision and/or scenario.

A 24-year-old male college student was presented at the ESU health clinic. He looked tired and pale. He presented because of a high fever and chest pain. He was afraid he was having a heart attack (a bad week of exams). He was examined immediately by the PA and an EKG strip was run. He had no evidence of acute heart problems. The attending physician visited the patient. He obtained the following history from the past 36 hours. The patient had a tight cough. He had significant muscle aches and pains. He had a bad headache and a fever of 101-103F.

The physician ordered a chest x-ray. It did not show any significant consolidated inflammation suggestive of pneumonia. The patient showed significant nasal drainage and a moderately tight, but productive cough on physical exam. He had a fever of 101F and generally inflamed mucous membranes. A rapid Strep test showed no evidence of Streptococcal infection and his tonsils and adenoids had been removed.

1. What type of infection do you believe he has? what microorganism is causing this disease?

2.  From the complaint and physical examination, which of the symptoms lead you to your choice of agent? how did you come to that conclusion?

3. From the history, which of the information confirmed your choice? What is the treatment for this illness/disease?

4. Which of the following is most likely to follow this infection? How did you come to that solution of the treatment? In other words, why is it that treatment?

 

Please reference and cite and also keep both studies separated and numbered! And keep the answered questions and explanation together, about a paragraph for each question. thank you!

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Case study 6

 

A 70-year-old patient with Alzheimer’s disease was brought to the emergency room by the staff of a local nursing home. He presented as lethargic with a sallow complexity. He had an admission temperature of 102.4F and a respiratory rate

of 33/minute. During respiration, the right side of his chest moved better than the left. He showed dense consolidation of the lower lobe of the left lung on physical exam. A sputum sample revealed blood and a greenish color.

A chest x-ray showed tight consolidation of the left lung with evidence of formation of cavities in the lung tissue from cytotoxic damage. The patient complained of chills in the exam room, combined with his fever. A smear of his

sputum demonstrated no acid-fast bacteria.

 

1. What type of infection do you believe he has? what microorganism is causing this disease?

2.  From complaint and physical examination, which of the symptoms lead you to your choice of agent? how did you come to that conclusion?

3. From the history, which of the information confirmed your choice? What is the treatment for this illness/disease?

4. Which of the following is most likely to follow this infection? How did you come to that solution of the treatment? In other words, why is it that treatment?
Please reference and cite and also keep both studies separated and numbered! And keep the answered questions and explanation together, about a paragraph for each question. thank you!​

Which of the following is consistent with current literature regarding the epidemiology of dependent personality disorder? I” A Dependent personality is more common in men than in women. A dependent personality disorder is more common in young children than in I" older ones. C Persons with chronic physical illness in childhood may be most susceptible to t" this disorder. It… DElandConly

Which of the following is not consistent with what is known about postpartum psychosis? Symptoms of postpartum psychosis can often begin within days of delivery. B The average time of onset of symptoms of postpartum psychosis is within 2 to 3 weeks of delivery. Florid psychotic symptoms are usually preceded by prodromal signs such as insomnia, restlessness, agitation, and mild cognitive deficits. This disorder primarily affects first-time mothers, and there is very little risk of postpartum psychosis in subsequent pregnancies.