Lab Assignment: Ethical Concerns

Lab Assignment: Ethical Concerns

Lab Assignment Ethical Concerns

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

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 capacity to make important decisions. Effective decisions for resuscitation would wait, but until then, I will make every attempt to stabilize the patient.

I will respect the wish of the patient and the family. If the patient and the family agree that they need all interventions and the patient is stable on life support machines, then further investigation into brain function and viability will be conducted (Ozmen et al., 2019). Diagnostic testing would reveal the extent of brain damage and cardiopulmonary stability that would aid in determining the status of my patient and viability. I will then discuss the patient’s condition with the family to get ready for any result that would come from the treatment offered to the patient.

A confirmation that the brain cells of the patient are dead and the family is not ready to stop the life support measures, the hospital can change the status of the patient to “do not resuscitate” with approval from two physicians (Nelson & Lewis, 2017). However, providers will ensure that the family confirms the decision. This would be important in avoiding ethical dilemmas.

 

 

References

Nelson, A., & Lewis, A. (2017). Determining brain death: basic approach and controversial issues. American Journal of Critical Care, 26(6), 496-500. https://doi.org/10.4037/ajcc2017540

Ozmen, O., Aksoy, M., Atalay, C., Aydin, M. D., Dostbil, A., Ince, I., & Sener, E. (2019). Are unresponsive dilated pupils an indicator for brain death? an evaluation of Edinger Westphal nucleus in rabbits with brain death. Annals of Medical Research, 26(10), 2376-2381. https://annalsmedres.org/index.php/aomr/article/view/3711 

Rossetti, A. O. (2017). Clinical neurophysiology for neurological prognostication of comatose patients after cardiac arrest. Clinical Neurophysiology Practice, 2, 76-80. https://doi.org/10.1016/j.cnp.2017.03.001

ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Lab Assignment: Ethical Concerns

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.

Pick one out of the scenario and write on:

Please follow assignment instructions and you may pick one of the following ethical case studies:

CASE STUDY 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.

CASE STUDY 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.

CASE STUDY 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

CASE STUDY 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.

CASE STUDY 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.

CASE STUDY 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.

CASE STUDY 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.

Rubric:

Write a detailed 1-page narrative (not a formal paper) addressing the following:
· Explain 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.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.

Lab Assignment: Ethical Concerns

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion

Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.