Directions:
Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.
Mr. D
Mr. D is a 90-year-old man who was admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction. Mr. D has a long history of comorbidities including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest. Mr. D tells the physician that he wants all measures taken to save his life.
Imagine that you are the nurse assigned to provide care to Mr. D, and address the following:
1. Considering Mr. D’s advanced age, what are the benefits/risks associated with providing life-sustaining measures?
2. What factors should you consider based on Mr. D’s age and health history?
3. If Mr. D were your family member, how would you respond to his decision?
Addressing the scenario of Mr. D, a 90-year-old man with multiple comorbidities who has opted for life-sustaining measures in the event of cardiopulmonary arrest, raises important ethical and practical considerations in nursing care.
1. **Benefits/Risks of Life-Sustaining Measures:**
Providing life-sustaining measures such as CPR and mechanical ventilation can potentially extend Mr. D’s life during a critical event like myocardial infarction. The benefit lies in the chance to reverse the acute condition and provide him with more time. However, at his advanced age and with his extensive medical history (hypertension, diabetes, CHF), the risks are significant. These may include:
– **Physical Stress:** CPR and ventilation can cause physical trauma, especially to fragile ribs and organs in elderly patients.
– **Quality of Life:** There’s a risk that even if successful, Mr. D may not regain the same quality of life due to prolonged recovery or complications.
– **Ethical Considerations:** Balancing the benefit of prolonging life versus potential suffering and loss of autonomy is crucial.
2. **Factors to Consider:**
– **Advanced Age:** Mr. D’s age is a significant factor due to physiological frailty, reduced resilience to stressors, and potentially diminished capacity to recover from invasive procedures.
– **Comorbidities:** His medical history of hypertension, diabetes, and CHF complicates outcomes. These conditions increase the likelihood of poor recovery post-resuscitation.
– **Quality of Life Preferences:** Understanding Mr. D’s values and preferences regarding quality of life and end-of-life care is essential. His desire for life-sustaining measures indicates a preference for maximizing survival chances, which should be respected.
3. **Personal Response as a Family Member:**
As a family member of Mr. D, I would respect his autonomy and decision-making capacity. While acknowledging the potential risks and challenges associated with life-sustaining measures at his age, I would support his choice if it aligns with his values and desired outcomes. It’s crucial to have open discussions to ensure he fully understands the implications of his decision and to provide emotional support through this process. Additionally, exploring options for advanced care planning and ensuring his wishes are documented comprehensively would be prudent.
In conclusion, caring for Mr. D involves navigating complex ethical considerations surrounding end-of-life decisions, respecting his autonomy, and ensuring his wishes are honored while considering the potential benefits and risks of life-sustaining measures given his age and health status.
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