Anemia Caused By Stomach Bleeding Discussion Paper
A, an 88-year-old Japanese woman, was hospitalized with anemia, lower leg edema and ascites. She was living alone while receiving care in a day-care center for older people. Mrs A’s only family was her daughter, who lived in the same town, but it was a day-care center worker who brought Mrs to the hospital. The daughter arrived at the hospital later. The physician said to Mrs A: ‘Your hemoglobin level six months ago was 12 , but now it is only 4 . Your anemia may possibly be caused by stomach bleeding so a thorough examination is absolutely necessary. If not treated, terrible problems might occur, and no treatment means you will likely die.’ The patient, however, refused the treatment by saying that she was too old and the gastric camera was terrifying. The daughter also said, ‘I want to respect my mother’s decision. I knew that her legs and her abdomen were swollen but because of her age I did not want her to be brought to hospital. As far as she does not want treatment, l agree with her.’ 1. What should the nurses do and why? 2. It seems reasonable to start by considering the patient’s choice: should the nurses simply respect this? 3. Since Mrs A is anemic, with a hemoglobin level of only , is this affecting her competence to make a decision about the situation? 4. Why does she say she is too old? 5. Does she think she simply does not deserve access to further treatment because she is a ‘burden’ on others? 6 why is she terrified of the gastric camera? 7 Does she understand what this is? Anemia Caused By Stomach Bleeding Discussion Paper
This solution was written by a subject matter expert. It’s designed to help students like you learn core concepts.
Anemia is a medical condition characterized by a deficiency in the number or quality of red blood cells in the body, or a reduction in the amount of hemoglobin, the protein that carries oxygen in the blood. Hemoglobin is responsible for the red color of blood, and a decrease in its levels can lead to fatigue, weakness, and shortness of breath. There are many different types and causes of anemia, including iron deficiency anemia, vitamin deficiency anemia, and hemolytic anemia, among others. Treatment options vary depending on the underlying cause, but may include dietary changes, supplements, medication, or blood transfusions.
1. The nurses should first try to understand Mrs A’s reasons for refusing treatment and provide her with the necessary information to help her make an informed decision. They should also discuss the potential consequences of not treating her anemia and the underlying cause of her condition. The nurses should also involve the daughter in the decision-making process and ensure that Mrs A’s wishes are respected while considering her best interests and safety. 2, While respecting the patient’s autonomy is crucial, it is also essential to ensure that the patient’s decision is informed, voluntary, and not influenced by coercion or undue pressure. Therefore, the nurses should engage in a dialogue with Mrs A to understand her reasons for refusing treatment and provide her with relevant information to make an informed decision. 3. Anemia can affect a patient’s cognitive function and ability to make decisions, particularly in severe cases. Therefore, the nurses should assess Mrs A’s capacity to make decisions and consider involving a capacity assessment team if needed. If Mrs A is found to lack capacity, the nurses should follow appropriate protocols to determine the best course of action while considering her wishes and safety. Anemia Caused By Stomach Bleeding Discussion Paper
4. Mrs A may feel that her age makes her too weak or vulnerable to undergo further medical procedures, or she may believe that her life expectancy is limited and that medical treatment will not improve her quality of life. 5. It is not clear from the information provided whether Mrs A believes that she is a burden on others and does not deserve access to further treatment. However, this is a common concern among older adults, and it is essential to address such feelings and provide support and reassurance. 6. Mrs A may be afraid of the gastric camera due to concerns about discomfort or pain during the procedure, or she may have a fear of medical equipment or procedures in general. Alternatively, she may be anxious about the potential diagnosis or treatment that may result from the examination. 7. It is not clear from the information provided whether Mrs A understands what the gastric camera is and how it is used. Therefore, the nurses should provide clear and simple explanations of the procedure and its purpose, using visual aids or other communication tools if needed, to ensure that Mrs A has a clear understanding of what is involved.
Mrs A, an 88-year-old Japanese woman, was hospitalized with anemia, lower leg edema, and ascites. Despite the physician’s recommendation, Mrs A refused treatment due to her fear of the gastric camera and her age. The nurses should respect Mrs A’s decision while ensuring that she has the necessary information to make an informed decision and considering her best interests and safety. Anemia Caused By Stomach Bleeding Discussion Paper