10-04-2010, 05:16 AM
An 86-year-old man with Alzheimer disease is admitted to the hospital for treatment of pneumonia. The patient has chronic obstructive pulmonary disease; coronary artery disease, which developed after he underwent four-vessel coronary artery bypass grafting (CABG) 10 years ago; and New York Heart Association class 3 congestive heart failure. His living will, created at the time of his CABG, calls for full efforts to resuscitate him if necessary. A family meeting is scheduled for the next morning. At 2 A.M., a nurse discovers that the patient is blue in color and has no pulse; the nurse initiates CPR and alerts you regarding the need for emergent resuscitation. An electrocardiogram shows no electrical activity.
What should you do at this time?
A. Proceed with resuscitation because of the patient's living will
B. Proceed with resuscitation until permission to stop resuscitation is
obtained from the family
C. Decline to proceed with resuscitation on the basis of medical futility
D. Continue resuscitation for 30 minutes because the nurse initiated CPR
E. Decline to proceed with resuscitation because the patient's previous living
will is void, owing to the fact that it was not updated at the time of admission
What should you do at this time?
A. Proceed with resuscitation because of the patient's living will
B. Proceed with resuscitation until permission to stop resuscitation is
obtained from the family
C. Decline to proceed with resuscitation on the basis of medical futility
D. Continue resuscitation for 30 minutes because the nurse initiated CPR
E. Decline to proceed with resuscitation because the patient's previous living
will is void, owing to the fact that it was not updated at the time of admission