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Ethics and the DNR

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The patient has large necrotic sore on her back, is laying in bed. Some of the time the patient can follow and understand, and focus on someone talking to her, while responding yes or no by shaking her head.

She is too weak to write and cannot hold a pen. She grimaces when she is moved and is in physical pain. The Rns are having problems having her eat.

The guardian has never met the patient but has placed a DNR. And when the patient was asked if she agrees with the DNR order, she shakes her head no.

Now my questions for you are , please identify the issue and indicate the regulation or best practice principle involved.

How should the organization/provider respond to the issue? What should the organization/provider do to prevent future issues or mitigate any future harm/damage to the patient or the organization?

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Solution Summary

A discussion on the ethical dilemma of who chooses to implement a DNR order. Nurses are often found in the middle of issues regarding DNR orders.

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A healthcare ethics scenario is assessed clearly.

Summary of scenario

Mr. Martinez was a seventy-five-year-old chronic obstructive pulmonary disease patient. He was in the hospital because of an upper respiratory tract infection. He and his wife had requested that CPR not be performed should he require it. A DNR order was written in the charts. In his room on the third floor, he was being maintained with antibiotics, fluids, and oxygen and seemed to be doing better. However, Mr. Martinezâ??s oxygen was inadvertently turned up, and this caused him to go into respiratory failure. When found by the therapist, he was in terrible distress and lay gasping in his bed.

Question

Should Mr. Martinez be transferred to intensive care, where his respiratory failure can be treated by a ventilator and his oxygen level can be monitored? For your response to the Mr. Martinez scenario, think about the contextual features, quality of life, patient preferences and medical indications. Then, provide an ethical rationale.

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