NURS 6512 The Ethics Behind Assessment

NURS 6512 The Ethics Behind Assessment

NURS 6512 The Ethics Behind Assessment

Case Study 1: Parents of a 5-year-old boy who oppose the immunization of their son

Immunization is an important component of health promotion for all children in the US. All the states require that children should be fully vaccinated before they begin their education. However, 47 states consider exemptions due to religious or philosophical reasons. Vaccinations are important in preventing unnecessary hospitalizations as well as mortalities. Therefore, it would be important for nurse practitioner to seek additional information from the parents about their reasons for opposing vaccination for their son. Often, parents decline vaccinations for their children due to the influence of factors such as religious beliefs and practice. The nurse practitioners should obtain information related to the religious affiliation of the family, beliefs and practice and their influence on the uptake on immunization services (Giubilini, 2021). The information on the religious beliefs, values and practices of the family will provide the nurse practitioner with the insights into the factors contributing to the decisions that the parents are making.

The nurse practitioner should also determine the knowledge and attitude of the family towards immunization. Information such as the knowledge of the parents about the benefits and risks of immunization should be obtained. The nurse practitioner should also obtained information about the fears and misconceptions that the family might have towards immunization. Low level of knowledge or misconceptions may affect the utilization of immunization services by the family (Berry et al., 2017). As a result, the nurse practitioner should educate the family about the benefits of immunization alongside the anticipated side effects.

The nurse practitioner may utilize educational resources such as videos and photographs of the consequences of failing to immunize their child to increase the level of understanding of the patients (Mossey et al., 2020). Health education will help the family to make informed decisions about whether their son should be immunized or not.

References

Berry, N. J., Henry, A., Danchin, M., Trevena, L. J., Willaby, H. W., & Leask, J. (2017). When parents won’t vaccinate their children: A qualitative investigation of australian primary care providers’ experiences. BMC Pediatrics, 17(1), 19. https://doi.org/10.1186/s12887-017-0783-2

Giubilini, A. (2021). Vaccination ethics. British Medical Bulletin, 137(1), 4–12. https://doi.org/10.1093/bmb/ldaa036

Mossey, S., Hosman, S., Montgomery, P., & McCauley, K. (2020). Parents’ experiences and nurses’ perceptions of decision-making about childhood immunization. Canadian Journal of Nursing Research, 52(4), 255–267. https://doi.org/10.1177/0844562119847343

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

• 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.

Learning Objectives

Students will:

• Apply evidence-based practice guidelines to make an informed healthcare decision
• Apply ethical considerations to a health assessment response
• Apply concepts, theories, and principles relating to sports physicals and well-child and well-woman examinations
• Identify concepts, theories, and principles related to advanced health assessment
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Learning Resources

Required Readings (click to expand/reduce)

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 24, “Sports Participation Evaluation”

In this chapter, the authors describe the process of a sports participation evaluation. The chapter also states the most common conditions encountered in a sports participation evaluation.

• Chapter 25, “Putting It All Together”

In this chapter, the authors tie together the concepts introduced in previous chapters. In particular, the chapter has a strong emphasis on the patient-caregiver relationship.

Tingle, J. & Cribb, A. (2014). Nursing law and ethics (4th ed.). Chichester, UK: Wiley Blackwell.

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.

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

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 healthcare 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. (2017). 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.

Document: Final Exam Review (Word document)

Required Media (click to expand/reduce)

Module 4 Introduction

Dr. Tara Harris reviews the overall expectations for Module 4. Consider how you will manage your time as you review your media and Learning Resources for your Case Study Lab Assignment and your Final exam (3m).
Sports Participation Evaluation – Week 11 (12m)
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Assignment 1: Lab Assignment: Ethical Concerns

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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:
o Select one scenario, and reflect on the material presented throughout this course.
o What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
o 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.

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By Day 6 of Week 11

Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
• Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.
• Click the Week 11 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 11 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 11 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:
Submit your Week 11 Assignment draft and review the originality report.

Submit Your Assignment by Day 6 of Week 11

To participate in this Assignment:
Week 11 Assignment

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Assignment 2: Lab Assignment: Practice Assessment: Mental Health Examination
The Lab Assignment
Complete the following in Shadow Health:
• Mental Health (Practice)
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Exam: Week 11 Final Exam

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This exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.
This exam will be on topics covered in weeks 7, 8, 9, 10, and 11. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit.

By Day 7 of Week 11

Complete the Final Exam.
Submission and Grading Information
Submit Your Final Exam by Day 7 of Week 11.

To Complete this Exam:
Week 11 Exam

________________________________________
What’s Coming Up?
Congratulations! After you have finished all of the assignments for this week, you have completed the course. Please submit your Course Evaluation by Day 7.

Case study 2 depicts a single father who accompanies his 17-year-old daughter to a women’s health clinic and requests a pregnancy test for his daughter. The daughter does not consent to the test and appears uneasy. Vital health assessment information required to establish if the girl is pregnant includes her menstrual history (Dyer et al., 2018). The nurse should inquire about the date of her last menstrual period (LMP), menstrual pattern, duration of her menses, and frequency. In addition, the nurse should obtain the client’s sexual history, including if she is sexually active, the contraceptives she uses, and the frequency of using contraceptives. The nurse should also gather information on presumptive signs of pregnancy, including amenorrhea, nausea, vomiting, generalized malaise, and breast tenderness (Gadsby et al., 2021).

This case presents an ethical dilemma since the girl’s father insists on a pregnancy test against her wish. The provider also has an ethical duty to promote the confidentiality of the patient’s information. Thus, I would ensure privacy when interviewing the girl in her father’s absence and assure her that the information she gives will be kept confidential. To address this ethical dilemma, I would observe the rule that the patient, in this case, is the girl and not the parent (Larcher & Brierley, 2018). Thus, I would only perform the pregnancy test if the girl consented. This is because conducting the test against the girl’s wish poses the risk of psychological harm.

Sharkey and Griffiths (2019) explain that children above 16 years are considered competent to consent to treatment, including pregnancy testing. Patients should be asked sensitively about the likelihood of pregnancy and offered a pregnancy test with their consent if there is doubt. If the girl continues to decline even after counseling her, I would inform her father that a pregnancy test cannot be conducted against the patient’s wish since it will violate her right to autonomy.

References

Dyer, J., Latendresse, G., Cole, E., Coleman, J., & Rothwell, E. (2018). Content of First Prenatal Visits. Maternal and child health journal, 22(5), 679–684. https://doi.org/10.1007/s10995-018-2436-y

Gadsby, R., Ivanova, D., Trevelyan, E., Hutton, J. L., & Johnson, S. (2021). The onset of nausea and vomiting of pregnancy: a prospective cohort study. BMC pregnancy and childbirth, 21(1), 10. https://doi.org/10.1186/s12884-020-03478-7

Larcher, V., & Brierley, J. (2018). Developing guidance for pregnancy testing of adolescents participating in research: ethical, legal and practical considerations. Archives of disease in childhood, 101(10), 980–983. https://doi.org/10.1136/archdischild-2018-310725

Sharkey, E., & Griffiths, S. (2019). The ethics of pregnancy testing. Anaesthesia & Intensive Care Medicine, 20(9), 511-514.https://doi.org/10.1016/j.mpaic.2019.06.006