08 Oct This is an assignment. Only 20% of plagiarism is a
This is an assignment. Only 20% of plagiarism is allowed. Believe it or not; it’s not a soap note (Yeah). I want the focus to be Scenario 2 of the 49-year-old woman. I have found and example paper. I work in the emergency room and we saw people with a terminally ill diagnosis, and they have either stopped breathing, or their heart has stopped. We always have to focus on the code status of the patient and the wishes of the next of kin. Which in this case is the husband? Most people of this age do not have a living will, but have most likely have discussed with their spouse their wishes if something were to happen. If nothing is legally documented, we do what the husband says; no matter how difficult it may be for the children. The husband knows his wife wishes, and that shound be honored. We find at times the husband is so confused and can not make that discussion; then we are the ER team do everything in our power to resuscitate this patient. Just because this patient has advanced cancer doesn’t mean we shouldn’t give her a fighting chance after all that could be her will. We do in our ER have Ultra Sound capaibilites to see if the heart is actively beating. Assignment: Ethical Concerns As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur? In this Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios. Scenario 1: The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines. Scenario 2: A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance. Scenario 3: A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment. Scenario 4: A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled. Scenario 5: A 17-year-old boy has come in for a check-up after a head injury during a football game. He has indicated that he would like to be able to play in the next game, which is in 3 days. Scenario 6: A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity. Scenario 7: A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient unit at a hospice to receive end-of-life care, but his wife wants him to remain at home. To prepare: • Select one scenarios, and reflect on the material presented throughout this course. • What necessary information would need to be obtained about the patient through health assessments and diagnostic tests? • Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected. To complete: Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least 3 different references from current evidence based literature. NURS 6512: ADVANCED HEALTH ASSESSMENT AND DIAGNOSTIC REASONING Week 11: The Ethics Behind Assessment Consider the following scenarios: • You are a nurse at a large county hospital. One of your patients is leaning toward selecting a certain radical treatment for cancer, to which the family is in opposition. The family is concerned about making the correct decision and asks for your advice. • The state of Oregon has passed a “Death with Dignity” Act that allows for euthanasia in certain situations. One of your patients suffering from terminal cancer is thinking of moving there to take advantage of this law and asks your opinion. Throughout this course, you have explored a wide range of health assessments and abnormal examination findings. Although you have predominantly focused on the procedural aspects of health assessment, this week, you will focus on ethical considerations that should be taken into account when advising patients or their families. This week, you will consider how evidence-based practice guidelines and ethical considerations factor into health assessments. You will also evaluate health assessment concepts related to sports physicals and well-child and well-woman examinations. Tingle, J. & Cribb, A. (2014). Nursing law and ethics (4th ed.). Chichester, UK: Wiley Blackwell. Retrieved from http://site.ebrary.com/lib/waldenu/reader.action?docID=10774345 Furman, C. D., Earnshaw, L. A., Farrer, L. A. (2014). A case of inappropriate apolipoprotein E testing in Alzheimer’s disease due to lack of an informed consent discussion. American Journal of Alzheimer’s Disease & Other Dementias, 29(7), 590-595. doi:10.1177/1533317514525829. Retrieved from the Walden Library Databases. Navarro-Illana, P., Aznar, J., & Díez-Domingo, J. (2014). Ethical considerations of universal vaccination against human papilloma virus. BMC Medical Ethics, 15(29). doi:10.1186/1472-6939-15-29 Retrieved from http://www.biomedcentral.com/1472-6939/15/29 Maron, B. J., Friedman, R. A., & Caplan, A. (2015). Ethics of preparticipation cardiovascular screening for athletes. Nature Reviews Cardiology, 12(6), 375–378. doi:10.1038/nrcardio.2015.21 Retrieved from the Walden Library Databases. May, K. H., Marshall, D. L., Burns, T. G., Popoli, D. M. & Polikandriotis, J. A. (2014). Pediatric sports specific return to play guidelines following concussion. The International Journal of Sports Physical Therapy, 9(2), 242–255. PMCID: PMC4004129. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004129/ American Academy of Pediatrics. (2008). Recommendations for preventative pediatric health care (periodicity schedule). Retrieved from https://www.harmonyhpi.com/WCAssets/illinois/assets/IL_MedicaidProviderManual_PEM_AdultPHGsForProviders.pdf This resource provides recommendations for preventative pediatric health care from infancy through adolescence. The periodicity schedule covers a variety of areas from health history to measurements, developmental/behavioral screenings, physical exams, procedural screenings, and oral health. Rourke, L., Leduc, D., & Rourke, J. (2011). Rourke Baby Record. Retrieved from http://rourkebabyrecord.ca/ This website provides information on the Rourke Baby Record (RBR). The RBR supplies guidelines on growth and nutrition, developmental surveillance, physical exam parameters, and immunizations for well-baby and child care
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