Dr. C. Everett Koop, formerly Surgeon General of the United States, presents the following A A situation. It involves a 5-year-old girl who has a type of childhood brain tumor that Dr. Koop has studied for many years. The child's original tumor was removed, but it has recurred in spite of all known treatment. Dr. Koop writes: "I know her days are limited and that the longer she lives the more likely she is to have considerable pain. She might also become both blind and deaf." He goes on to explain that the child is severely anemic and this causes C her to be unaware of what is happening to her. If he treats the anemia, this may prolong her life. At the same time, it will increase her awareness of pain and ability to understand her situation. Anticancer drugs can be prescribed, but he knows these have no chance of curing the child. Dr. Koop poses the question "Would it be better to let this little girl slip into death quietly... or should we prolong her life?"

1. It can be argued that it is Dr. Koop's responsibility child's condition, including the anemia. Do you agree? Explain your answer. as a physician to treat all aspects of the

2. Should anyone else be involved in making the decision about how to treat this child? Explain why

3. Discuss what you think should be done for this child.

The nurse working at the senior center notices mrs jones, a 78-year old crying. the nurse approach mrs jones and asks if she needs . mrs jones stars “ i am so embarrassed. i had another accident and my pants are all wet. it’s like i’m a baby. i never should have come to the senior center." whar factors may be contributing to urinary incontinence? how should the nurse respond to mrs jones?

Harold, a fifty-eight year old grocery store manager, had recently been waking up in the middle of the night with abdominal pain. this was happening several nights a week. he was also experiencing occasional discomfort in the middle of the afternoon. harold decided to schedule an appointment with his physician. the doctor listened as harold described his symptoms and then asked harold some questions. he noted that harold's appetite had suffered as a result of the pain he was experiencing and as a result of the fear that what he was eating may be responsible for the pain. otherwise, harold seemed fine. the doctor referred harold to a physician that specialized in internal medicine and had harold make an appointment for a procedure called an endoscopy. the endoscopy was performed at a hospital later that week. during the procedure, a long, thin tube was inserted into harold's mouth and directed into his digestive tract. the end of the tube was equipped with a light source and a small camera which allowed the doctor to observe the interior of harold's stomach. the endoscope was also equipped with a small claw-like structure that the doctor could use in order to obtain a small tissue sample from the lining of harold's stomach, if required. the endoscopy revealed that harold had a peptic ulcer. analysis of a tissue sample taken from the site showed that harold also had an infection that was caused by helicobacterpylori bacteria. the doctor who performed the endoscopy gave harold prescriptions for two different antibiotics and a medication that would decrease the secretion of stomach acid. the doctor also instructed harold to schedule an appointment for another endoscopy procedure in 6 months. 1. list the subjective findings in this case study. 2. what is an endoscopy? (2 points) what is a biopsy? 3. how was a biopsy performed on harold? 4. differentiate between gastric and duodenal ulcers by location. 5. what role does h. pylori play in the formation of peptic ulcers? 6. define occult and frank blood. (4 points) what is a guaiac test? 7. how can peptic ulcers cause bleeding? 8. why were antibiotics prescribed? 9. why would a medication that would decrease the secretion of stomach acid be beneficial?

Anurse is assessing a client who is receiving a peripheral iv infusion and notes infiltration the insertion site. which of the following actions should the nurse take? a. flush the iv catherer. b. elevate the extremity. c. apply pressure to the iv site. d. slow the infusion rate.