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Health, Medicine, Nursing
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Assignment 7 Health, Medicine, Nursing Essay Paper

Essay Instructions:

Assignment: 7
For this assignment, please answer the following (1500 words). Please don’t forget to add an objective page and a conclusion page. Thanks.
CASE 1
The older adult male patient was admitted to the hospital emergency center with major blunt abdominal trauma following a car crash. In the emergency center, the nurse carried out the physician’s order for a dose of morphine for the patient’s pain, which he said was an 8 on a scale from 1 to 10. After being given the morphine, the patient’s blood pressure dropped significantly, and the patient went into cardiac and respiratory arrest after lapsing into unconsciousness.
The nurse alerted the physician, who immediately intubated the patient and sent him to the operating room to be resuscitated and then for exploratory surgery to determine the extent and cause of the abdominal bleeding. The patient was never revived, and he died the next day in the facility’s intensive care unit. The family has brought a wrongful death lawsuit, alleging that the morphine was the cause of the patient’s demise. In the lawsuit, there were no allegations of excessive dose, improper administration of the medication, or inattentive monitoring by the nurses in the emergency center.
QUESTIONS
1. Was the nurse negligent for not questioning the use of morphine for a patient with blunt abdominal pain before administering the dose of morphine?
2. Would knowing that the patient’s blood pressure was 148/94 when the morphine was administered impact the finding of the trial court?
3. What evidence would you argue in the nurse’s defense regarding the care of this patient?
4. How would you decide this case?
CASE 2.
An 82-year-old patient who was herself a retired physician was admitted to a rehabilitation facility after surgery to repair a broken hip. During her stay at the rehabilitation facility, she woke one morning feeling nauseous and began vomiting blood. The rehabilitation physician believed that the patient had an upper gastrointestinal bleed for which she needed to be hospitalized. She was immediately taken to the emergency department at the acute care hospital located on the same cam--pus as the rehabilitation facility. She was evaluated and monitored in the hospital emergency department for two hours and then moved to the hospital’s intensive care area for continuous monitoring and treatment. Complications caused her death in the early hours of the subsequent morning. Her estate subsequently filed a lawsuit for an EMTALA violation, alleging that the patient was not stabilized as mandated by the Act.
QUESTIONS
1. What initial care should the patient have received in the emergency center?
2. Did the emergency department staff meet the standards of care for a patient with these presenting signs and symptoms?
3. Was the admission to the intensive care area a violation of the EMTALA law?
4. How would you decide this case and what provisions of the EMTALA law would you anticipate the court enumerated in its holding?
CASE 3
An elderly woman was admitted to the hospital from home, then admitted to a skilled nursing facility for rehabilitation, and then to an assisted living facility. She had chronic kidney failure that required dialysis. Sometimes her mental status deteriorated into confusion, usually just before her dialysis appointments. At some point, she also suffered a stroke, which seemed to affect her cognitive status. Over the course of a few weeks, she spoke with an attorney several times on the phone, discussing with him how to write her last will and testament. She had had a life-long rift with one of her siblings and chose not to give any-thing in her will to the now deceased sibling’s children. She also wanted to give substantial amounts to charity rather than to her other two siblings and their children. The attorney mailed her will to her at the assisted living facility. The social worker and a second individual from the facility’s staff witnessed her signature on the document in her room at the assisted living facility. When she died, the children of her estranged sibling contested the will and sued in court to have the will vacated.
QUESTIONS
1. What types of questions should be asked of the social worker and the other individual who witnessed her signature on the will?
2. What other evidence should be requested of the nursing staff to best ascertain her cognitive ability at the time she dictated how she wanted the will drafted and at the time she signed the document?
3. Does the fact that she had been estranged for some years from the sibling whose children are now suing factor into the final decision of the court?
4. How would you decide this case?

Essay Sample Content Preview:

Assignment
Name
Institution/ Affiliation
Case one
Question one
While nearly all medicines have side effects, especially when administered wrongly, caregivers need to be cautious with the choice of drugs they administer to their patients. This also applies to analgesic drugs such as morphine that is prescribed to relieve pain. Naturally, nurses are expected to follow doctors unless they have safety concerns or conflicts with personal beliefs. Surgical tradition holds that analgesics should not be used for patients with abdominal pain until an effective diagnosis and management plan is recommended by a surgeon (Brewster et al., 2000). It is believed that analgesics delay diagnosis, mask signs and symptoms, leading to increased risk of mortality and morbidity. Therefore, the nurse was negligent as he or she ought to have questioned the use of morphine for a patient with abdominal pain before a responsible surgeon takes history and performs a physical examination.
Question two
The ideal blood pressure for a healthy human being should be 90/60mmHg and 120/80mmHg. Blood pressure above 120/80mmHg means the patient is at the risk of developing high blood pressure if the corrective measures are not undertaken. Although many opioids have a little or negative impact on cardiac contractility, they are also associated with decreased cardiac function when administered with other medications (Chen, A., & Ashburn, 2015). However, if the analgesics are administered in large quantities, they may lead to increased blood pressure. As such, since no incidence of overdose was recorded, there would be no impact if the court found the patient had a higher blood pressure of 148/94.
Question three
While nurses must administer the right medication and quantity, nurses still administer the wrong dosage to patients. For example, in the United States, nearly 9000 people die each year due to medication error, needless to mention the hundreds of thousands of others who report adverse reactions or other difficulties related to the medication (Human, 2018). However, nurses should take this loophole of administering the wrong prescription or dosage. In this case, the nurse did not administer morphine to harm the patient. The nurse did not administer the wrong dosage or inattentive monitoring of the patient or improper administration of the medicine. Nevertheless, the nurse's actions constituted negligence that was largely contributed by the physician on duty. Therefore, it is wrong to convict the nurse on the grounds of a wrongful death suit as there is no evidence that the nurse wanted to kill the patient.
Question four
In my opinion, the nurse is not guilty as his actions do not directly constitute the patient's death. Although the nurse is negligent in questioning the use of morphine in patients with abdominal pain, he or she was following the physician’s orders. Therefore, the case should be dismissed on the grounds of unintentional medical error, which are common in hospitals across the world.
Case two
Question one
Responding quickly to injured or critically ill patients is an important intervention. These interventions ensure that the patients stabilize before an expert medical professional arrives to administer s...
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