Feb 23, 2024 Assignment 1: Lab Assignment: Ethical Concerns
Assignment 1: Lab Assignment: Ethical Concerns
Assignment 1 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).
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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).
Has she had any previous hospitalizations especially for cardiac arrest? (Baker & Marco, 2020).
Is there next of kin that needs to be contacted to follow up about their condition? (Baker & Marco, 2020).
Previously has she stated any resuscitation or medication preferences if a cardiac arrest occurs? (Baker & Marco, 2020).
Does patient have any cultural, religious or personal beliefs that should be considered during her resuscitation or treatment efforts? (Baker & Marco, 2020).
How long she has been in that state (unconscious and nonresponsive)? (Baker & Marco, 2020).
Does patient have planned advance directive? (Baker & Marco, 2020).
What is the patient’s medical history? Does she have an underlying health risk factor or conditions for cardiac arrest? (Baker & Marco, 2020).
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
Assignment 1 Lab Assignment Ethical Concerns
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
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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.
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
Assignment 2: Lab Assignment: Practice
Assessment: Mental Health Examination
The Lab Assignment
Complete the following in Shadow Health:
Mental Health (Practice)
Exam: Week 11 Final Exam
Photo Credit: Getty Images/iStockphoto
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
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_MedicaidProviderMan
ual_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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