Disagreement and distress among physicians, nurse practitioners, ...

[iveyjurea]

Disagreement and distress among physicians, nurse practitioners, and critical care nurses can lead to
 
  a. emotional distress only.
  b. ethical distress only.
  c. emotional and ethical distress.
  d. pessimistic opinions of care.

Question 2

A 68-year-old patient is admitted to the critical care unit with reports of midchest pressure radiating into the jaw and shortness of breath when walking up stairs
 
  The patient is admitted with a diagnosis of rule out myocardial infarction. The history portion of the assessment should be guided by
 
  a. medical history.
  b. history of prior surgeries.
  c. presenting symptoms.
  d. a review of systems.

[ririgirl15]

Answer to Question 1

C
Nurses and doctors frequently disagree about the futility of interventions. Sometimes nurses consider withdrawal before physicians and patients do, and they then believe the care they are giving is unnecessary and possibly harmful. This issue is a serious one for critical care nurses because emotional and ethical distress can lead to burnout.

Answer to Question 2

C
For a patient in acute distress, the history taking is shortened to just a few questions about the patient's chief complaint, precipitating events, and current medications. For a patient who is not in obvious distress, the history focuses on the following four areas: review of the patient's present illness; overview of the patient's general cardiovascular status; review of the patient's general health status, including family history of coronary artery disease (CAD), hypertension, diabetes, peripheral arterial disease, or stroke; and survey of the patient's lifestyle, including risk factors for CAD.