Assignment Task
Mrs Ramirez was admitted to the hospital for wrist surgery secondary to rheumatoid arthritis. Postoperatively, she is stabilised and transferred to the general surgery unit.
Mrs Ramirez’s medications include digoxin, lasix, coversyl, captopril, oroxine, aspirin and prednisone. When administering morning medications, Mrs Ramirez refuses her
aspirin and prednisone, and the nurse holds the medications. Over the next three days, Mrs Ramirez continues to refuse the prednisone and coversyl and the
medication is not administered. The RN who was looking after Mrs.Ramirez neither inform nor document in the chart.
On the third postoperative day, Mrs Ramirez becomes hypertensive, tachycardia, and has a decrease in the level of consciousness. Her vital signs have altered somewhat; her heart rate has increased to 92bpm, her blood pressure has increased to 150/100; her temperature is 38.0 C, Stat blood sent for a full blood cell count and
chemistry panel, and the doctor is notified of the change in patient status. On review of the patient’s record, the doctor notes that Mrs Ramirez has not received her prednisone for four days. Mrs Ramirez has been on prednisone for the past 5 years for her rheumatoid arthritis, and the doctor begins to treat the patient for
acute adrenal insufficiency.
You are on the morning shift and Mrs Ramirez is allocated to you. After handover when you went to her room to check the vital signs she complains of abdominal pain,
dizziness, fatigue, severe weakness and seems quite confused. Her condition is markedly different from the last time you attended to her. You checked her vitals
signs and recorded.Her vital signs are followed; Temp 38.70C, P 96, R 24, BP 160/98. It was your tea break time and went for a break. On return, you found her on
the floor, bleeding from the operation site and the dressing removed. You immediately call for help and press the emergency bell.
You need to consider:
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Get Help Now!- The legal and ethical concerns that the situation in the case scenario raises.
- The possible actions or inactions that could be taken and the implications of those actions.
- Which ethical principles, doctrines or concepts apply to the actions/inactions put forward and if so, how?
- Do any of the ethical principles conflict with each other or with the law?
- Which torts or other legal concerns apply to your suggested actions/inactions?
- Consider the Code of Conduct, Code of Ethics and RN Standards of Practice (2016), how do they apply to this situation?
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