Question

A 45-year-old female was brought to the Emergency Department by ambulance at 8 AM. Upon awakening, the patient's husband noticed she had an unsteady gait and her speech was slurred. When they went to bed the night before, at 11 PM, the patient had no deficits. A head CT was negative for abnormalities. The patient's condition continued to deteriorate, and she required intubation and mechanical ventilation. TPA was not administered. The patient was admitted to the Intensive Care Unit for a diagnosis of ischemic stroke. On day three, the patient stabilized enough to be extubated and removed from the ventilator. However, she was responsive only to painful stimuli. On day five, the physician ordered a surgical consult for insertion of a feeding tube and to begin tube feedings. The husband is distraught and confused, stating he does not think his wife would want to live like this. On day seven, the Nurse Manager arranges a family meeting with the husband, the patient's parents, the physician, the case manager and the primary nurse to discuss the patient's situation and to develop a plan of care in accordance with her wishes. Neither the husband nor the parents ever remember having a conversation about the patient's wishes regarding artificial nutrition and hydration. The husband and the parents have opposing views regarding what they think would be the patient's wishes. As the primary nurse, you developed a trusting and therapeutic relationship with the family. You are asked to participate in the conversation to help educate the patient about options Initial Response Your initial response must address the following: Did the patient receive treatment in accordance with best practices for stroke care? Why or why not? (In your response, include identifying best practices.) Describe the role of the nurse in advocating for the patient's rights and needs. Identify legal, financial, and ethical perspectives of your stance • Defend the con position to withhold or withdraw life-sustaining treatment.

Answer 1

No. The patient did not receive initial treatment. TPA is a Tissue type plasminogen activator(TPA) it is a blood thinner and it is for ischemic stroke to dissolve the clot which obstructs the blood flow to the brain. It should b given within the first 3 to 5 hours from the stroke onset. This timing is important to prevent hemorrhage inside the brain.
As a nurse ensure patient safety. provide adequate information to the patient about their condition and educate them to manage their condition. protect patient rights by knowing their wishes and patient choices for their treatment. maintain a therapeutic relationship and avoid error, help the patient and family to find resources that best suit the patient's wellbeing.
Ethical perspective based on right or wrong of action. It includes Autonomy, beneficence, non-maleficence, and equity as a basic principle. legal rights in health care include competency to make decsions that should be considered as age eligibility aboive18 years, ability to make a decision right decsions, advance directive, and living will for persons wish about health care decsions, power of attorney for patient behalf as a health care decisions that best for the patient. cost-effective treatment for health care services that reduce cost.
withholding of life support is legally and it is the principle of informed refusal. Patient care should focus on illness, preference, values, beliefs, and cultures. treatment withdrawal provides a negative choice of care and abandonment. It is a euthanasia or assistance inpatient suicide.