Assignment 1: Lab Assignment: Ethical Concerns NURS 6512

Assignment 1: Lab Assignment: Ethical Concerns NURS 6512

Assignment 1 Lab Assignment Ethical Concerns NURS 6512

Case Study Assignment

Various health assessments information, diagnostic tests, evidence-based guidelines and ethical considerations are essential when treating and diagnosing unconscious patients with cardiac arrest. Case study two about a 33-year-old woman who has advanced stage breast cancer and is currently admitted at the emergency room with cardiac arrest. She has been accompanied by her boyfriend in the ambulance and she is not married illustrates how the emergency should be handled by an advanced nurse practitioner (Baker & Marco, 2020).

I will take a number of actions as an advanced nurse practitioner to handle the scenario. First, I will carefully evaluate the patient’s vital signs that include her heart rate, respiration, level of awareness, and blood pressure and are crucial for such a patient in this state, in order to determine how well she is doing. In addition, I would look into her medical background to see if she had ever received breast cancer treatment (Perkins & Nolan, 2022).

She is in cardiac arrest, thus the best course of action would be to start advanced cardiac life support, which includes performing CPR and giving the appropriate drugs, in accordance with current evidence-based guidelines. Evidence for resuscitation has long been compiled using therapeutic and scientific suggestions (Perkins & Nolan, 2022).

Also, I would take the input of the patient’s boyfriend, especially in terms of decision-making. The boyfriend is capable to offer vital information at this stage. Potential questions to ask would include: (Baker & Marco, 2020).

1. Has she had any previous hospitalizations especially for cardiac arrest? (Baker & Marco, 2020).
2. Is there next of kin that needs to be contacted to follow up about their condition? (Baker & Marco, 2020).
3. Previously has she stated any resuscitation or medication preferences if a cardiac arrest occurs? (Baker & Marco, 2020).
4. Does patient have any cultural, religious or personal beliefs that should be considered during her resuscitation or treatment efforts? (Baker & Marco, 2020).
5. How long she has been in that state (unconscious and nonresponsive)? (Baker & Marco, 2020).
6. Does patient have planned advance directive? (Baker & Marco, 2020).
7. What is the patient’s medical history? Does she have an underlying health risk factor or conditions for cardiac arrest? (Baker & Marco, 2020).
8. Does she have any adverse reactions or allergies to medication? (Baker & Marco, 2020).

Advanced Practice Nurse Response

In terms of ethics, I would consider the advance decisions that medical

professionals must make for patients who are unconscious or in a vegetative state. As there is no advance directive in this circumstance, I shall consult the medical ethics committee or local regulations and laws to identify the appropriate route of immediate action after establishing if patient had an advance directive intended (Zhang, et al., 2021).

Here, I will take into account the necessity to provide appropriate medical care while simultaneously protecting the patient’s rights and interests. In this situation, beneficence is the most relevant ethical factor to take into account. In this case, the medical staff has a moral duty to provide care that is in the patient’s best interests. If the results of the diagnostic tests indicate that her illness is terminal, it can involve providing therapies that aim to extend her life and provide comfort in this case (Baker & Marco, 2020).

When managing the case, an advanced nurse should follow evidence-based recommendations and nursing practice ethics. Before conducting tests, administering treatments, and making drug recommendations, the nurse will take the necessary precautions. Better outcomes for patient and partner will be made possible by careful adherence to the rules and ethical considerations. However, in the absence of explicit directives, discussing the patient’s condition with ethics committee would indeed be possible (Zhang, et al., 2021).

Legally, let’s say someone who is not the patient’s spouse brings the patient in. The healthcare professional in that situation will only divulge information to individuals who have lawfully gained their consent or to those who are permitted to do so by law. However, after confirming his relationship with the patient, the lover will be treated as a designated representative and permitted to obtain some information about the patient’s condition (Perkins & Nolan, 2022).

References

Zhang, H., Zhang, H., Zhang, Z., & Wang, Y. (2021). Patient privacy and autonomy: A    comparative analysis of cases of ethical dilemmas in China and the United States. Links            to an external site.BMC Medical Ethics, 22(1). https://doi.org/10.1186/s12910-021-  00579-6

Perkins, G. D., & Nolan, J. P. (2022). Advanced life support update. Critical Care             26(73),             https://ccforum.biomedcentral.com/articles/10.1186/s13054-022-03912-6.

Baker, E. F., & Marco, C. A. (2020). Advance directives in the emergency department. J Am CollEmerg Physicians Open 1(3), 270-275

Case Study 1: The Parents of a 5-Year-Old Boy have accompanied their Son for his Required Physical Examination

Nurses often face ethical dilemmas in their practice.  Ethical dilemmas predispose nurses to conflicts in the most sound decision that is associated with minimal harm and optimum benefits to those involved. Nurses should have knowledge and skills in addressing ethical dilemmas in their practice. They should utilize models of ethical decision making as well as institutional policies that guide the approaches to addressing ethical dilemmas in practice. Therefore, the purpose of this paper is an examination of a case study of parents who do not want their son to be immunized prior to joining the kindergarten.

Assessment Information

The selected case study for analysis involves parents of a 5-year-old boy who accompanied their son for his required physical examination before starting kindergarten. The parents are opposed to him receiving any vaccines. Immunizations play an important role in promoting the health of the public. Immunizations prevent the risk of the population being affected by communicable diseases such as polio and tuberculosis.

Patients are expected to ensure that children get all the prescribed immunizations to protect them from health problems (Smith et al., 2017). However, the uptake of immunizations may be low in families and communities that do not support the use of immunizations due to effect of cultural values and beliefs.

As an advanced practice nurse, I am expected to perform comprehensive assessment to develop accurate diagnosis. I need to obtain information about the previous immunization history, surgical and medical history and undertake comprehensive physical examination. Obtaining information about immunization history is important to determine whether the parents have been against it since the early childhood or not. It will also be used to determine the vulnerability of the child to infections.

History about medical and surgical history is important to determine whether the child has any underlying medical condition or history of surgery. Physical examination should be performed to determine any abnormalities such as injuries, abuse and violence. I also need to obtain information about the religious history of the family, since some religious practices influence the uptake of immunizations in some communities (Quinn et al., 2018).

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Responding to the Scenario

I will respond to the scenario by first educating the parents about the reasons for their decision that their son should not be immunized. Obtaining such information because it will provide insights into whether the parents have an informed basis for their decisions or not. It will also guide the determination of whether their decision is attributed to factors such as religious and cultural beliefs. The other intervention that I will embrace will be educating the parents about the importance of immunizations for their son. Health education may increase their understanding and cause a change in their perception towards immunization (Crocker-Buque et al., 2017; Hui et al., 2018). Resources such as videos and educational brochures may be used to increase their understanding.

Conclusion

Hesitancy to use immunizations is an ethical issue in nursing practice. Individuals may reject immunization services due to the influence of religious and cultural beliefs. Nurse practitioners have a critical role to play in assessing patients to make informed decisions on the uptake of immunization services. They also educate them about the importance of immunizations to facilitate informed decision-making.

References

Crocker-Buque, T., Edelstein, M., & Mounier-Jack, S. (2017). Interventions to reduce inequalities in vaccine uptake in children and adolescents aged <19 years: A systematic review. J Epidemiol Community Health, 71(1), 87–97. https://doi.org/10.1136/jech-2016-207572

Hui, C., Dunn, J., Morton, R., Staub, L. P., Tran, A., Hargreaves, S., Greenaway, C., Biggs, B. A., Christensen, R., & Pottie, K. (2018). Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review. International Journal of Environmental Research and Public Health, 15(10), 2065. https://doi.org/10.3390/ijerph15102065

Quinn, S. C., Jamison, A., An, J., Freimuth, V. S., Hancock, G. R., & Musa, D. (2018). Breaking down the monolith: Understanding flu vaccine uptake among African Americans. SSM – Population Health, 4, 25–36. https://doi.org/10.1016/j.ssmph.2017.11.003

Smith, L. E., Amlôt, R., Weinman, J., Yiend, J., & Rubin, G. J. (2017). A systematic review of factors affecting vaccine uptake in young children. Vaccine, 35(45), 6059–6069. https://doi.org/10.1016/j.vaccine.2017.09.046

It is not uncommon for nurses advanced practice nurses to encounter situations where a patient’s wishes regarded their health are in conflict with the family’s wishes, professional experience, or evidence hence creating ethical dilemmas (Haahr et al., 2020). Therefore, it is important for an advanced practice nurse to make informed decisions that can positively impact the patient’s condition.

The case considered in this assignment is for a 60-year-old man who was diagnosed with inclusive body myositis several years ago and is currently facing a rapid decline in his condition. While the patient prefers to be at home and get end-of-life care from there, the wife is of the opinion that her husband is admitted to the inpatient care setting.

Making a better decision regarding this case requires particular assessment information. Inclusive body myositis exposes the patients to falls; hence this patient is at risk of falling (Weihl, 2019).  I would assess the patient’s quality of life and ability to undertake daily life activities. Assessing the proficiency of the home caregiving would be key in determining whether the partner can offer good care and give moral support.

An appropriate response to this scenario requires that I consider ethics as an advanced practice nurse. Guided by nursing ethics, I would strive to educate the family and the patient to ensure that they have sufficient knowledge regarding the condition and how the family can help take care of the patient. After the assessment, I would also collaborate with the patient’s wife and other family members to help come up with an appropriate care plan which is likely to have a better impact on the patient’s condition.

These actions are in accordance with the principles of beneficence and nonmaleficence, which involve doing the right and good thing for the patient and doing no harm (McDermott-Levy et al., 2018). I would also ensure that I treat the patient’s medical details with confidentiality.

References

Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing Ethics, 27(1), 258-272. https://doi.org/10.1177%2F0969733019832941

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing Outlook, 66(5), 473-481. https://doi.org/10.1016/j.outlook.2018.06.013

Weihl, C. C. (2019). Sporadic inclusion body myositis and other rimmed vacuolar myopathies. CONTINUUM: Lifelong Learning in Neurology, 25(6), 1586-1598. Doi: 10.1212/CON.0000000000000790

It is not uncommon for nurses advanced practice nurses to encounter situations where a patient’s wishes regarded their health are in conflict with the family’s wishes, professional experience, or evidence hence creating ethical dilemmas (Haahr et al., 2020). Therefore, it is important for an advanced practice nurse to make informed decisions that can positively impact the patient’s condition.

The case considered in this assignment is for a 60-year-old man who was diagnosed with inclusive body myositis several years ago and is currently facing a rapid decline in his condition. While the patient prefers to be at home and get end-of-life care from there, the wife is of the opinion that her husband is admitted to the inpatient care setting.

Making a better decision regarding this case requires particular assessment information. Inclusive body myositis exposes the patients to falls; hence this patient is at risk of falling (Weihl, 2019).  I would assess the patient’s quality of life and ability to undertake daily life activities. Assessing the proficiency of the home caregiving would be key in determining whether the partner can offer good care and give moral support.

An appropriate response to this scenario requires that I consider ethics as an advanced practice nurse. Guided by nursing ethics, I would strive to educate the family and the patient to ensure that they have sufficient knowledge regarding the condition and how the family can help take care of the patient.

After the assessment, I would also collaborate with the patient’s wife and other family members to help come up with an appropriate care plan which is likely to have a better impact on the patient’s condition. These actions are in accordance with the principles of beneficence and nonmaleficence, which involve doing the right and good thing for the patient and doing no harm (McDermott-Levy et al., 2018). I would also ensure that I treat the patient’s medical details with confidentiality.

Assignment 1: Lab Assignment: Ethical Concerns

It is not uncommon for advanced practice nurses to encounter situations in which a patient’s wishes regarding their health conflict with the wishes of their family, professional experience, or evidence, resulting in ethical quandaries (Haahr et al., 2020). As a result, it is critical for an advanced practice nurse to make informed decisions that can improve the patient’s condition.

This assignment considers the case of a 60-year-old man who was diagnosed with inclusive body myositis several years ago and is currently experiencing a rapid decline in his condition. While the patient would prefer to die at home, the wife believes that her husband should be admitted to an inpatient care facility.

Making a better decision in this case necessitates specific assessment information. Because inclusive body myositis puts patients at risk of falling, this patient is at risk of falling (Weihl, 2019). I would evaluate the patient’s quality of life and ability to perform daily activities. Assessing the competence of the home caregiver is critical in determining whether the partner can provide good care and moral support.

As an advanced practice nurse, I must consider ethics when responding to this scenario. In accordance with nursing ethics, I would strive to educate the family and the patient to ensure that they have sufficient knowledge about the condition and how the family can assist in the patient’s care. Following the assessment, I would work with the patient’s wife and other family members to develop an appropriate care plan that is more likely to improve the patient’s condition.

These actions are consistent with the principles of beneficence and nonmaleficence, which entail doing what is right and good for the patient while causing no harm (McDermott-Levy et al., 2018). I would also make certain that the patient’s medical information is kept private.

References

Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing Ethics, 27(1), 258-272. https://doi.org/10.1177%2F0969733019832941

McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing Outlook, 66(5), 473-481. https://doi.org/10.1016/j.outlook.2018.06.013

Weihl, C. C. (2019). Sporadic inclusion body myositis and other rimmed vacuolar myopathies. CONTINUUM: Lifelong Learning in Neurology, 25(6), 1586-1598. Doi: 10.1212/CON.0000000000000790

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 Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

To Prepare

Review the scenarios provided by your instructor for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your scenarios.

Based on the scenarios provided:
Select one scenario, 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.

The Lab Assignment

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 three different references from current evidence-based literature.

By Day 6 of Week 11

Submit your Assignment.

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Submit Your Assignment by Day 6 of Week 11

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Week 11 Assignment

APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.

☐  The title page is present. APA format is applied correctly. There are no errors.

☐ The introduction is present. APA format is applied correctly. There are no errors.

☐ Topic is well defined.

☐ Strong thesis statement is included in the introduction of the paper.

☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.

☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☐ All sources are cited. APA style and format are correctly applied and are free from error.

☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.

Individual Forum: This is a private forum where you can ask me questions or leave messages for me. At least once every 24 hours, this will be checked.

The patient is in advanced-stage cancer, and the effective discussion should be on life care and discussion of wishes and needs. In the case presented, the patient has tested positive for advanced-stage cancer and is presented in the emergency unit for cardiac arrest. In this write-up, I will provide a detailed narrative explaining the health assessment information required for a diagnosis regarding the presented case.

I would determine the cardiac arrest using an ECG and the life-saving measures as defined in the ACL protocols (Nelson & Lewis, 2017). Once I am able to stabilize the patient, I would ask the boyfriend if the patient has an advanced directive or will concerning the resuscitation status. The advanced directive is a legal document relaying more information on the life savings of the patient (Rossetti, 2017). In this case, I would ask the boyfriend who can connect to the next of kin in case the boyfriend is not the next of kin. This would happen if the patient is unconscious or does not have the mental capaci