. What are the medical priorities to consider? Administrative…

Question Answered step-by-step . What are the medical priorities to consider? Administrative… .  What are the medical priorities to consider?  Administrative priorities?CASE Study:John is a 66 year-old man brought in by after his daughter, Karen. John was in the yard playing with his grandsons when he suddenly fell down in a faint. His grandsons reported that John had complained of chest tightness and then fainted. He was transported to the hospital where he was noted to be hypotensive secondary to a urosepsis. The hypotensive episode precipitated a small myocardial infarction and he ruled in with an elevated troponin. He was hospitalized and stabilized. He has rarely ever seen a doctor. You are told that he does not trust or believe in the medical system after his wife Marie died 5 years ago due to metastatic colon cancer. Past Medical HistoryHe has always hated hospitals. His dislike for hospitals and physicians was further reinforced by the sudden and unexpected death of his wife.He was told that he had high blood pressure and high cholesterol at a health fair many years ago, but refused to “let quacks mess with my body.” His diet is heavy on red meat, potatoes and fatty foods, and low in fruits, vegetables and whole grains.  He had a CT scan of his chest when he had a bout of pneumonia 5 years ago and was found to have a lung lesion, for which he underwent a right lower lobectomy.  He refused further follow-up. Current IllnessThe cardiac echo revealed decreased LV function with an estimated ejection fraction of 20% and severely thickened and or calcified, and severely stenotic Aortic Valve (is 0.4 cm squared with a mean gradient of 35 mm Hg)Cardiologists want to do a catheterization for further evaluation but the patient refused.Pulmonary repeated a CT scan of thorax and several mediastinal lesions were visible and consistent with metastatic disease. This morning he awoke and could not get dressed himself, or walk the stairs due to shortness of breath.  His pulse ox is 85% on room air. He is crying and says he is afraid to die. Health Science Science Nursing Share QuestionEmailCopy link Comments (0)

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