Mrs. Jones, 78 years old, arrived in the emergency department (ED) via ambulance. She was alert and oriented, but was having episodes of lost consciousness. She was put on the cardiac monitor and her vital signs were obtained. Her cardiac rhythm was normal. Her vital signs were as follows: Temperature 97.3°F, Pulse 43, respirations 26, blood pressure 100/58 and O2 saturation of 94% on room air. Additionally, Mrs. Jones was vomiting and had 2 loose, incontinent stools. She was pale, cool to touch and diaphoretic. Auscultation of her lungs revealed expiratory wheezes. Her brother reported finding her in her living room on the couch. He reported that she was difficult to rouse, and becoming concerned, he called 911. Prior to the ambulance arriving, Mrs. Jones vomited several times and her brother noted a significant amount of partly dissolved pills in the emesis. Upon checking her medicine cabinet, he found several prescription bottles empty and some over the counter medications open in the cabinet. He brought these medication bottles to the ED. Poison control was contacted and they recommended giving her activated charcoal to absorb the medications. The charcoal was offered and Mrs. Jones refused, stating that she wanted no treatment and had attempted to kill herself for a reason. Upon speaking to her brother, it was learned that her husband had died about one year earlier and that she had several new diagnoses in the last few months; including: Diabetes mellitus, anorexia (with marked weight loss), sleep disturbances, and mild dementia. She had been having difficulty with the management of these new illnesses and was still grieving for her husband. Because it was an attempted suicide, a crisis management team was c... ... middle of paper ... ...e depression from dementia. The Nurse Practitioner, 28(3), 18-27. Retrieved from www.tnpj.com on 2/19/04. Pelkonen, M. & Marttunen, M. (2003). Child and adolescent suicide: Epidemiology, risk factors and approaches to prevention. Pediatric Drugs, 5 (4), 243-265. Retrieved via Academic Search Primer on 3/25/04. http://web3.epnet.com Waern, M., Rubenowitz, E., Runeson, B., Skoog, I., Wilhelmson, K., & Allebeck, P. (2002). Burden of illness and suicide in elderly people: Case-control study. BMJ, 324(8), 1355-1357. Retrieved from www.bmj.com on 2/19/04. Zito, Safer, DosReis, Gardener, Soeken, Boles, & Lynch (2002). Rising prevalence of antidepressants among US youths. Pediatrics, 109 (5), 721-727. Retrieved via Academic Search Primer on 3/25/04. http://web3.epnet.com
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
Mrs. A is a 71-year-old widow with CCF and osteoarthritis who has recently been exhibiting quite unusual behavior. Her daughter is concerned about her mother 's ability to remain independent and wishes to pursue nursing home admission arrangements. She fears the development of a dementing illness. Over the last two to three months Mrs. A has become confused, easily fatigued and very irritable. She has developed disturbing obsessive/compulsive behavior constantly complaining that her lace curtains were dirty and required frequent washing. Detailed questioning revealed that she thought they were yellow-green and possibly moldy. Her prescribed medications are:
The treatment priorities of the registered nurse upon admission to the emergency department are as follows; within the first 10 minutes of Mr. Bronson’s arrival to the emergency department begin a 12 lead ECG. Assess Mr. Bronson’s vitals heart rate, blood pressure, respiratory rate, oxygen saturation, and administer oxygen 2-4 liters via nasal cannula (Sen, B., McNab, A., & Burdess, C., 2009, p. 19). Assess any pre hospital medications, and if he has done cocaine in the last 24 hours. At this time, the nurse should assess Mr. Bronson’s pain quality, location, duration, radiation, and intensity. Timing of onset of current episode that brought him to the emergency room, any precipitating factors, and what relieves his chest pain.
Depression is becoming more common among adults due to the stresses that accompany everyday living. Along with the increasing numbers of adults suffering from depression, an ongoing rise in depression among the youth is also becoming a growing concern. Depression induced by peer pressure, bullying or other stresses can contribute to the growing numbers of adolescents taking antidepressants. According to Dr. Vincent Iannelli, there is an estimate that 3 percent of children and about 12 percent of teens suffer from depression. What most people are misinformed about is that they believe that antidepressants will prevent users from having depression or stop it completely. This is a misconception about antidepressants that can be misleading. The idea of taking a supplement to combat an internal emotional conflict should be severed out as a means of treatment unless ultimately necessar...
In her paper entitled "Euthanasia," Phillipa Foot notes that euthanasia should be thought of as "inducing or otherwise opting for death for the sake of the one who is to die" (MI, 8). In Moral Matters, Jan Narveson argues, successfully I think, that given moral grounds for suicide, voluntary euthanasia is morally acceptable (at least, in principle). Daniel Callahan, on the other hand, in his "When Self-Determination Runs Amok," counters that the traditional pro-(active) euthanasia arguments concerning self-determination, the distinction between killing and allowing to die, and the skepticism about harmful consequences for society, are flawed. I do not think Callahan's reasoning establishes that euthanasia is indeed morally wrong and legally impossible, and I will attempt to show that.
The denial of food and fluids to Terri Schindler-Schiavo, the 36 year old Florida woman in a vegetative state since a heart attack, has caused Americans to ponder the fact that any one of them could be in this woman's place for a variety of reasons, like an auto accident, fall, mishap, etc. And most Americans don't want to be treated by their family as Terri is being treated by her husband - being denied food and fluids in order to hasten death.
Mrs. Jones was admitted to the hospital for evaluation due to hyperglycemia related to diabetes. Her blood sugar was 350 and her physical exam revealed dry skin and mucous membranes.
To sanction the taking of innocent human life is to contradict a primary purpose of law in an ordered society. A law or court decision allowing assisted suicide would demean the lives of vulnerable patients and expose them to exploitation by those who feel they are better off dead. Such a policy would corrupt the medical profession, whose ethical code calls on physicians to serve life and never to kill. The voiceless or marginalized in our society -- the poor, the frail elderly, racial minorities, millions of people who lack health insurance -- would be the first to feel pressure to die.
This paper will address some of the more popular points of interest involved with the euthanasia-assisted suicide discussion. There are less than a dozen questions which would come to mind in the case of the average individual who has a mild interest in this debate, and the following essay presents information which would satisfy that individual's curiosity on these points of common interest.
Medical science has made great strides to allow us to save more lives than ever before. Through modern medicine, procedures, and technology we have the power to cure or reduce the suffering of people with conditions and diseases that were once thought to be fatal. We have discovered or much rather, we have created the so-called “fountain-of-youth”. Even so, modern medicine cannot treat all forms of pain and suffering. This technology that is seemingly beneficial for us today is also bringing about pain and distress to those who wish to end their prolonged life. One of the most controversial topics discussed this past decade has been that of assisted suicide.
Suicide is a very tragic life event for the victim, victim’s friends and family members and to society as a whole. We often hear about suicide deaths that occur in younger and middle-aged adults in the media but rarely is such attention given to elderly suicide (65 and older). In the United States there is a higher rate of suicide amongst the elderly than in any other part of the population. There are many factors to this problem, however depression among the elderly was recorded as the major contributing factor that lead them to suicide. Every elderly that committed suicide was reported to have been depressed. Understanding the contributing factors that lead to depression amongst the elderly might shed light on the issue. Many studies have shown that depression coupled with risk factors increase tendency of suicide ideation among the elderly. Risk factors such as chronic illness, pain, physical and mental disabilities, isolation, loneliness, role change (retirement), lack of financial security and social support, bereavement, alcohol abuse, hopelessness and dependability have been pointed out as major contributing factors for the high number of depression experienced by the elderly. Society has identified depression and suicides among the elderly are a social problem, but little have been done to educate the public.
There aren’t many cases where a child is required to get psychotherapy instead of prescribing the antidepressants. “Rarely does a clinical switch to an empirically proven psychotherapy like cognitive behavior therapy after a patient fails to respond to medication, although these data suggest that this might be the right strategy” (Friedman). Therapy will help to treat kids with depression because it lets the therapist see how their brain works during their daily life. “Indeed between 2000 and 2003, antidepressant use among children rose by 20% and grew by 49% among preschoolers” (Sun). Antidepressants have increased almost by half on preschooler when they could be getting therapy that would be to their advantage in their life because they are just starting their life and getting to know themselves. As for children, therapy will be convenient for them because they would get to know how they really feel and what they need help on with a therapist doing different exercises, to come to a conclusion on how serious their depression might be. “It's expected that many [health professionals] will stop prescribing these drugs and instead refer patients with suspected depression to mental health professionals” (“What are The Real Risk Of Antidepressants?”). With time, many professionals will stop prescribing these harmful drugs to these teenagers, and
Euthanasia and physician-assisted suicide has been a hot topic of debate for quite some time now. Some believe it to be immoral, while others see nothing wrong with it what so ever. Regardless what anyone believes, euthanasia and physician-assisted suicide should become legal for physicians and patients. Death is a personal situation in life. By government not allowing euthanasia and physician-assisted suicide they are interfering and violating patient’s personal freedom and human rights! Euthanasia and physician-assisted suicide have the power to save the lives of family members and other ill patients. Euthanasia and physician-assisted suicide should become legal however, there should be strict rules and guidelines to follow and carry out by both the patient and physician. If suicide isn’t a crime why should euthanasia and assisted suicide? Euthanasia and physician-assisted suicide should be legal and the government should not be permitted to interfere with death.
Critics are concerned about the growing use of psychiatric drugs taken by children and adolescents; these critics complain that physicians and psychiatrists are giving out these chemical solutions rather than psychotherapy due to expenses (Depression in Children--Part II). As psychotherapy can be quite expensive, so can antidepressants. These antidepressants have to keep getting refills and may at the end, end up costing more than a few weeks of psychotherapy that may be helpful. The consuming of antidepressants drugs prescribed for children and adolescents suffering from depression by their primary doctor can lead to many different side effects. It has been stated that, "Between 2005 and 2010, about 2 million U.S. adolescents ages 12 to 17 said that for more than half of the previous month, they routinely had felt sad, angry, disconnected, stressed out, unloved or possibly willing to hurt themselves--or others.(ProQuest Staff - Mental Health Timeline 1)" This was proven on May 25th, 2012, that adolescents feel different emotions; which are the disadvantages of antidepressants. Some people might get a certain reaction to the antidepressants, but some may not, not all bodies are alike. “Doctors should limit the medication of their patients, even if antidepressants come along with numerous different side effects, it is able to decrease the risk of
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.