: 55-year old female was transported to the floor after recovering from a surgical procedure. An epidural catheter with morphine was placed for post-operative pain control. Upon arrival, the patient complained of nausea and a headache prompting the on-call physician to prescribe, “Demerol 75mg every three hours for pain.” The preprinted medication orders from anesthesia stated “No narcotics, sedatives, or other respiratory depressants to be given during infusion of epidural medication and for 12 hours after epidural is discontinued except by order of anesthesia.” The nurse had not reviewed this order prior to obtaining and administering the new order for Demerol, a narcotic. Twenty minutes later, the patient was found unresponsive and aggressive resuscitation efforts were implemented, resulting in intubation and mechanical ventilation of the patient. When brain activity was not found, the family made the decision to take the patient off of life support and the patient died shortly thereafter. The patient’s family filed a lawsuit claiming negligence in administering the medication. A verdict was entered against the nurse for nearly P4 million. Guide Questions: 1. What is the situation? 2. What problem(s) need to be solved? 3. What are some solution or strategies should be used? 4. Evaluate pros/cons and underlying assumptions of these strategies? 5. What criteria will you use to evaluate your solution? 6. What are the Lesson to be Learned in this case?
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