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Posted: December 20th, 2021

What Strategies Should The Hospice Nurse Take To Resolve The Ethical Dilemma?

What Strategies Should The Hospice Nurse Take To Resolve The Ethical
Dilemma?
1. Mrs. Elle, 80 years of age, is a female patient who is diagnosed with end-stage cancer of the small
intestine. She is currently receiving comfort measures only in hospice. She has gangrene of her right foot
and has a history of diabetes controlled with oral agents. She is confused and the physician has
determined that she is unable to make her own informed decisions. The hospice nurse, not realizing that
the weekly order for CBC and renal prole had been discontinued, obtained the labs and sent them to the
nearby laboratory for processing. The abnormal lab results obtained later that day revealed that the
patient needed a blood transfusion. The hospice nurse updated the patient’s medical power of attorney
who was distressed at the report. The patient’s wishes were to die peacefully and to not have to undergo
an amputation of her right foot. But if the patient receives the blood transfusion, she may live long
enough to need the amputation. The patient’s physician had previously informed the medical power of
attorney that the patient would most likely not be able to survive the amputation. The patient’s medical
power of attorney had made the request to cease all labs so that the patient would receive comfort
measures until she died. The patient has no complaint of shortness of breath or discomfort.
1. What ethical dilemma exists?
2. Who are the stakeholders and what gains or losses do each have?
 

3. What strategies should the hospice nurse take to resolve the ethical dilemma?
2. The nurse receives a 12-year-old girl from the operating room after an emergent appendectomy due to
ruptured appendix. Upon arrival to the postanesthesia care unit, the patient is drowsy, but arousable to
voice; she was extubated in the operating room and is receiving oxygen by facemask at 40%. She has two
peripheral IVs in her left arm that are infusing Lactated Ringers solution at 100 mL/hr. A nasogastric tube
is attached to low constant suction, and a small amount of aspirate is noted. She has a urinary catheter
that is draining clear, yellow urine. Her abdominal dressing is dry and intact. Upon arousal, she complains
of abdominal pain.
1. What NANDA-approved nursing diagnoses may be relevant to this patient?
2. Once the nursing diagnoses are determined, what steps does the nurse take to complete the Planning
Phase of the Nursing Process?
3. What is the dierence between nursing diagnoses and collaborative problems?

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