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.

Rita schmidt, 74 years of age, is a female patient who was admitted to the surgical unit after undergoing removal of a section of the colon for colorectal cancer. the patient does not have a colostomy. the patient has several small abdominal incisions and a clear dressing over each site. the incisions are well approximated and the staples are dry and intact. there is a jackson-pratt drain intact with minimal serous sanguineous drainage present. the patient has a salem sump tube connected to low continuous wall suction that is draining a small amount of brown liquid. the patient has no bowel sounds. the foley catheter has a small amount of dark amber-colored urine without sediments. the patient has sequential compression device (scd) in place. the nurse performs an assessment and that the patient's breath sounds are decreased bilaterally in the bases and the patient has inspiratory crackles. the patient's cardiac assessment is within normal limits. the patient is receiving o2 at 2 l per nasal hg; heart rate 110 bpm; respiratory rate 16 breaths/min; and the patient is afebrile. the patient is confused as to place and time. cannula with a pulse oximetry reading of 95%. the vital signs include: blood pressure, 100/50 mm. a. explain the assessment parameters used to provide clues to detect postoperative problems early and the interventions needed. b. what gerontological postoperative considerations should the nurse make?