Ventilator Withdrawal, Essay Example

Patients who require palliative care often experience reduced levels of oral intake, yet IV fluids and parenteral nutrition do not necessarily improve quality of life in patients. Therefore, ANH is not a likely option for this patient, given his short remaining life span and his poor quality of life. Furthermore, it is recommended to use ice chips to manage thirst and to keep the patient as comfortable as possible during this final stage of life.

For this patient, ANH is not a recommended option because of the patient’s limited life span that remains. In addition, the risks of this practice outweigh the benefits, such as higher urine production which may lead to greater discomfort, coughing, nausea, and a risk of aspiration pneumonia. The patient should not be provided with this option because it would also be difficult for the family to witness and would minimize the level of comfort that is desirable during an already difficult stage. Finally, although the patient denies depression, this could be likely if ANH is pursued and makes the circumstances even worse than they already are.

For this patient, an appropriate treatment plan must be in place in order to provide the patient with the best possible outcomes, given his current health status. Specifically, the following recommendations must be considered: 1) Methylphenidate 5 mg once per day to improve fatigue management, and routine monitoring of the patient in order to determine if there are side effects and any improvements in fatigue that are observed; 2) Lorazepam 0.5 mg intravenously to manage anxiety, while monitoring the patient closely for respiratory depression, as well as other side effects and the potential improvement of anxiety; and 3) Offer education to the patient regarding his ability to rest at different periods throughout the day so that he is able to use his remaining energy efficiently, such as with limited exercise.