NR-601 Week 7 Janet Riley I Human Case Study Graded A 2024

NR-601 Week 7 Janet Riley I Human Case Study Graded A 2024 What is culture? culture refers to an everchanging set of shared symbols, beliefs, and customs that shapes individual and/or group behavior. George Hall is a 91 -year -old man visiting his physician to receive the results of a recent computed tomography scan of his abdomen. He is cognitively intact and still works 2 days a week. He is accompanied by his daughter Eleanor. She takes the doctor aside before the appointment and says, "Please do not tell my father any bad news. It would just kill him." If the physician were to agree, which ethical principles might this violate? a. Paternalism b. Autonomy c. Authenticity d. None of the above e. Answers a, b, and c B 7. Lenore White is an 80 -year -old woman who smokes two packs of cigarettes per day. She is hospitalized for pneumonia because she has presenting symptoms of cough and fever. On her second day of h ospitalization, she asks the nurse to please wheel her outside so she can smoke a cigarette. The nurse feels uncomfortable agreeing to this and speaks to her clinical nurse manager. What two ethical principles are in conflict? a. Beneficence and community b. Nonmaleficence and justice c. Autonomy and justice d. Autonomy and nonmaleficence D 8. Ms. Greta Thornberg is an 88 -year -old woman admitted to the hospital with a diagnosis of squamous cell carcinoma of the lung with metastases to liver. She has signe d a POLST indicating that she would like no limitation on life -sustaining measures, including resuscitation, artificial feeding, antibiotics, and hydration. On the second day of her stay, she sustains a stroke, resulting in global aphasia and hemiparesis. As her clinician, in addition to instituting appropriate medical management, you contact her healthcare agent and: a. Inform her healthcare agent of the POLST and notify her that it cannot be changed. b. Inform her healthcare agent of the POLST and notify her that the change of condition requires that the POLST be reviewed. c. Ask her healthcare agent to locate her Last Will and Testament. d. Since she has a signed POLST, there is no reason to contact t he healthcare agent. B differences between palliative and hospice care services The Center to Advance Palliative Care (CAPC) defines palliative care as healthcare for people with serious illness, which is focused on providing relief from symptoms and str ess—and improving quality of life and comfort —for both the patient and the patient's loved ones. Palliative care provides support for patients, families, and healthcare providers through: • symptom assessment and treatment; • assistance with decision makin g regarding the benefits and burdens of various therapies; • help in establishing goals of care; and • collaborative and seamless transitions between models of care (such as hospital, home, nursing homes, and hospice). For the geriatric patient, palliative care is most appropriately centered on limiting functional and cognitive impairment, minimizing caregiver burnout, and relieving the burden of physical and psychological symptoms. In contrast with hospice, which is generally offered once life -prolonging t reatments are no longer appropriate, palliative care can be offered simultaneously with disease -modifying, life -prolonging, or even potentially curative treatments for patients with serious illness. Reasons to refer to specialty palliative care • Refract ory symptoms • Difficulty with medical decision making • Healthcare team moral distress or burnout • Patient and/or family distress • Maladaptive coping styles: pessimism, high regret, passivity, tendency to blame others • Marital or familial conflict • History of severe psychiatric illness or suicidal ideation/attempts in patient or family • Limited/absent familial or community supports • Death anxiety • Spiritual distress (i.e., "God is punishing me") • History of ineffective coping in response to past st ressors • Lack of trust in healthcare providers We recommend couching the referral in the context of the patient's expressed needs. For example: • Identify and name the patient and family's specific challenges: "So, we've talked about how stressful things have been for you lately...." Then align the referral to those needs: "... and there's a team who have been really helpful to me when patients an d families need extra support." • Anticipate resistance and offer a different perspective to patients and families: "Some people worry that palliative care is just for people who are at the end of life, or that it's the same as hospice. The truth is that p alliative care teams help people at many different stages of illness." • Explain the purpose of palliative care: "Palliative care focuses on providing comfort, reducing stress, and improving quality of life for patients and loved ones...."