1. Read Critical Thinking Exercise,page 145, and discuss the following: a) What are the important data in relation to this situation? b.) State the ethical dilemma in a clear simple statement (right vs. right) c.) What are the choices of action and how do they relate to specific ethical principles? D.) What are the consequences of these actions? e.) What decision would you make? (Please use principles discussed in Chapter 7 to answer this question.) A. What are the important data in relation to this situation? Base of the situation presented in the case, upon seeing the patient in the emergency department, as a nurse you will first assess the patient. Apply the ABC’s in assessing patient because this is the foremost important of all. Then need to get patient’s vital signs, blood pressures, heart rate, respiratory rate, oxygen saturation and the pain level as this is considered the fifth vital sign. Then assess the injury sustained by the patient. You need to get the present history of illness or injury. The patient had a minor head injury, twisted ankle and a bruised arm from a fall from his roof. Also important is the past medical history, in which the patient had a history of asthma and smoking. It was not stated that the asthma is controlled, what was the medications taken. When the patient became cyanotic, dyspneic and became semiconscious, the emergency nurse did prepare the patient for possible intubation and admission to medical intensive care unit. But did he assess the patient very well? Is oxygen therapy was give since the patient is cyanotic and dyspneic? Did they assess the O2 saturation? Did they institute a laboratory test like ABG ( acid blood gases) ? When the resident physician came in to evaluate the patient, did he assess the patient completely and accurately? And what was the indication to do an emergency tracheostomy rather than doing the endotracheal intubation? The procedure that the resident performed just aggravated the patient’s condition since a major blood vessel was severed and the patient bleed profusely. Did they assess the proper placement of the tube? Did they request Xray and ABG? Did they continuously monitor the vital signs, since patient condition was not improving after that procedure? And lastly, why nobody in that emergency department that the oxygen tank that the client had been connected to was empty? Who’s responsible in maintaining and assuring that the needed equipments are ready in case of emergency? In fact it is an emergency department, and those emergency safety measures should have been done.
B. State the ethical dilemma in a clear, simple statement (right vs. right). The nurse in the emergency department (ED) was in dilemma to tell to the client’s wife what really occurred during the patient’s stay in the ED, the mistakes that were made in the treatment of her husband. He would like to relate what was happened but was in dilemma if this is the right time to do it and how can he tell that in fact he’s one of the staff involved during the treatment. The nurse doesn’t know what to say or act because it will create an aggravated condition for the client’s wife, the hospital and the staff. It is right to tell what was happened but it is also right to remain in silent and let the higher authority in the hospital initiate the proper action in dealing with the case? The emergency nurse also thinks of what would be the consequences of informing the client’s wife of the truth and what are the consequences of not informing her. C. What are the choices of action and how do they relate to specific ethical principles? If Bill will choose to inform client’s wife what had occurred during the treatment of her husband, will Bill still responsible for the said incident? This involves the principle of veracity, truthfulness. Will Bill would take the risk and just take what consequences it may arise by telling the truth. I know...
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