Question

You are the LPN assigned to a newly admitted cardiac patient with rule out myocardial infarction or heart attack (R/O MI).  The man is 48 years old.  He is overweight, and looks very ill.  He is perspiring, moaning with pain, and pale despite his Arabic complexion.  As you assist him to a position of comfort, you recognize that he is weak.  He is receiving oxygen and cardiac monitoring and has an IV running.  His wife and two small children are in the room.  The day-shift nurse said the family has been with M.A.since his admission.  The wife looks tired and frustrated with the crying children.  The day nurse also said M.A. refused pain medication.  The overall scene is not conducive to a cardiac patient or a critical care unit.

You sit down to talk with M.A. before you do your assessment.  It seems impossible.  The children are crying, and the wife is near tears.  M.A. suddenly jumps out of bed,pulling off his oxygen and most of the leads.  He then kneels on the floor, faces east, and starts to pray.

You are shocked and very concerned.  Your first reaction is to take charge of the situation by ordering the family out and getting assistance to put M.A back to bed.  They you remember some of the principles you learned in the Cultural Diversity module.  The most important thing is "there is a reason for every behavior."  Then you remember the patient advocate principles you learned.  None of them would be served if you raised your voice and started ordering people around.  What can you do?

There are some immediate and essential things you should do, and then you will have time to consider the more long-term solutions to the problems you encountered. Define the problems you encountered in this situation, and then resolve them while advocating for the patient.  Use the categories of immediate and essential long-term solutions.

Answer 1

Initially ask patient to calm down and return to bed and continue the treatment as before.frustrated patients initially they don't want to save their lives they will act like this.after to that we should only alone with the patient ask about his feelings make him to ventilate it out.

Immediately we should give patient oxygen and check his blood pressure , ECG and saturation level.

Then we should give counsel to the family and not to get emotional in front of patient. Because stress cause patient condition worse.