7): Shyla and Gloria Case Study Mrs.

7): Shyla and Gloria Case Study Mrs. Lyons was a 27 year old woman who recently gave birth prematurely to a set of twins. The infants were doing well but Ms Lyons hemorrhaged and required emergency surgery resulting in a hysterectomy. Severe loss of blood dropped her hemoglobin to 6.0. Because the patient and her husband were Jehovah’s witnesses, they refused blood transfusions as treatment for the low hemoglobin level. Chris Moore was the nurse caring for Mrs. Lyons after her surgery. Although he did not personally believe that patients should refuse blood transfusions, especially new mothers with dependent infants, he supported the rights of others to decide their health care in accordance with their religious beliefs. Shortly after admission to Mr. Moore’s unit, Mrs. Lyon’s hemoglobin began to drop. It was suspected that the patient was hemorrhaging from an unknown site in her body. Vasoactive drug therapy was begun to help maintain adequate perfusion of her body tissues and her cardiac output was constantly monitored. Mr. Lyons remained at his wife’s bedside and supported her repeated desire not to be transfused, even though to not do so might result in his wife’s death. Over the next 24 hours, Ms Lyons drifter in and out of consciousness and remained very close to death despite a slight rise in her hemoglobin level. As Mr. Moore was leaning over the patient, adjusting the IV tubing, he heard Mrs. Lyons whisper, “Please I don’t want to die– please don’t let me die.” Mr. Moore quickly asked Mr. Lyons if he heard what his wife said. He was on the other side of the room and had not heard his wife’s word. Even though the nurse believed that his wife was apparently changing her mind about receiving blood products, Mr. Lyons was reluctant to believe this and did not want to reserve her previous decisions. Mr. Moore knew that the patient condition required a rapid response to avert her death 8): Claudia and Nicole Case study Sarah was promoted to nurse manager because of her excellence in delivering patient care and recognizing leadership ability. She was a preceptor excellent charge nurse, outstanding patient advocate and chair of the practice council. Sarah has been a medical surgical nurse for over 10 years and loves the variety of patients under her care. She only recently completed her BSN degree and earned her certification in medical surgical nursing. When Sarah was in her position for less than 3 months, her immediate supervisor moved to another stated because of his wife’s promotion. This person had been a mentor, confidant, and recognized leader in the organization. Sarah tried to make the best of the situation and follow the direction of her new supervisor. However, right from the beginning, she found this person to be very focused on the negative. As an optimistic person, Sarah found this approach counter to her basic instinct about people. Every time she tried to discuss this approach, her director would say she was naive and that the staff was taking advantage of her good nature. The director used several of her recent projects failures to justify her position. However Sarah understood that these disappointments had been the results of staff illness and institutional reorgan 7): Shyla and Gloria Case Study Mrs. Lyons was a 27 year old woman who recently gave birth prematurely to a set of twins. The infants were doing well but Ms Lyons hemorrhaged and required emergency surgery resulting in a hysterectomy. Severe loss of blood dropped her hemoglobin to 6.0. Because the patient and her husband were Jehovah’s witnesses, they refused blood transfusions as treatment for the low hemoglobin level. Chris Moore was the nurse caring for Mrs. Lyons after her surgery. Although he did not personally believe that patients should refuse blood transfusions, especially new mothers with dependent infants, he supported the rights of others to decide their health care in accordance with their religious beliefs. Shortly after admission to Mr. Moore’s unit, Mrs. Lyon’s hemoglobin began to drop. It was suspected that the patient was hemorrhaging from an unknown site in her body. Vasoactive drug therapy was begun to help maintain adequate perfusion of her body tissues and her cardiac output was constantly monitored. Mr. Lyons remained at his wife’s bedside and supported her repeated desire not to be transfused, even though to not do so might result in his wife’s death. Over the next 24 hours, Ms Lyons drifter in and out of consciousness and remained very close to death despite a slight rise in her hemoglobin level. As Mr. Moore was leaning over the patient, adjusting the IV tubing, he heard Mrs. Lyons whisper, “Please I don’t want to die– please don’t let me die.” Mr. Moore quickly asked Mr. Lyons if he heard what his wife said. He was on the other side of the room and had not heard his wife’s word. Even though the nurse believed that his wife was apparently changing her mind about receiving blood products, Mr. Lyons was reluctant to believe this and did not want to reserve her previous decisions. Mr. Moore knew that the patient condition required a rapid response to avert her death SCIENCE HEALTH SCIENCE NURSING NSG 100

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