Nursing Case Study

Critical Thinking Case 1
The cases will provide students the opportunity to critically analyze and respond to questions on selected topics. APA is not required, but all questions must be answered concisely and thoroughly supported by the textbook, journals, and scholarly online sources. Number the answers to correspond with the question numbers.

Case Study One
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Critical Thinking Cases
Critical Thinking Cases
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeCompleteness of answers, which should include organized, clear, and concise information
25.0 pts
Full Marks
0.0 pts
No Marks
25.0 pts

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Case Study One

A.J., an 82 year-old female, was admitted three weeks ago with acute on chronic congestive heart failure (CHF) after presenting to the emergency department (ED) with c/o progressive worsening SOB, leg edema, and fatigue. She has a history of severe CHF, atrial fibrillation, myocardial infarction (MI), renal insufficiency, and hypothyroidism. Since admission, A.J. has needed intubation and ventilation for acute decompensated heart failure due to a massive MI. She is alert when not sedated but has been too unstable for a cardiac catheterization and has needed vasoactive medications to support her blood pressure. Her renal function has declined and plans are being made for hemodialysis. Today when speaking with A.J.’s husband, he conveys to you her nurse that “she would not have wanted all of this”.

1. Discuss the pros and cons of continued therapy and what role nursing can play in helping the patient and family.

2. What are the considerations that must be discussed before responding to the husband’s request to stop aggressive treatment?

3. What are advance directives and what are the implications for nursing care?

4. What resources should be considered for this patient and family?

5. Following a palliative care approach rewrite this scenario to reflect the philosophy and goals of palliation.

Total Points: 25.0


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