Feb 23, 2024 NURS 6512 Week 11 The Ethics Behind Assessment
NURS 6512 Week 11 The Ethics Behind Assessment
NURS 6512 Week 11 The Ethics Behind Assessment
Case Study Assignment
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.
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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).
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
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.
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
NURS 6512 Week 11 The Ethics Behind Assessment
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.
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NURS 6512 Week 11 The Ethics Behind Assessment:
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)
Lab Assignment: Ethical Concerns
Case study II depicts B.C., a 49-year-old female with advanced-stage cancer admitted to the emergency room with cardiac arrest. The health assessment information needed for a diagnosis of this patient includes asking the family if the patient developed signs and symptoms of impending cardiac arrest (Murphy et al., 2022). Thus, I would ask the family if the patient experienced a period of clinical deterioration with rapid, shallow breathing, a progressive deterioration in mental alertness, and unconsciousness. Health information on the presence of risk factors for Cardiac arrest will be needed including Coronary artery disease (CAD), Ischemic heart disease, Myocardial infarction, Heart failure, Arrhythmias, and Cardiomyopathy (Penketh & Nolan, 2022).
Furthermore, a physical assessment will be required to identify signs of cardiac arrest like pulselessness, impaired breathing pattern, absence of circulation, and cardiac rhythm disturbance (Murphy et al., 2022). A cardiac monitor should be applied to this patient to rule out if the patient has ventricular fibrillation (VF), ventricular tachycardia (VT), or asystole.
As an APN, I would respond to the case by taking part in Cardiopulmonary resuscitation (CPR), which should be performed immediately when a person is in cardiac arrest. Rapid initiation of uninterrupted chest compressions and early defibrillation of patients who are in Ventricular Fibrillation or Ventricular Tachycardia foster success in achieving a return of spontaneous circulation (Penketh & Nolan, 2022). The American Heart Association guidelines for the treatment of cardiac arrest further recommend rapid administration of a first dose of epinephrine for patients with non-shockable rhythms. However, I would inform the patient’s family of the interventions that will be implemented in the patient and seek the husband’s or next of kin’s consent to ensure respect for autonomy (Bjorklund & Lund, 2019). Besides, I will continuously update the family on the patient’s progress and refrain from giving the false hopes.
References
Bjorklund, P., & Lund, D. M. (2019). Informed consent and the aftermath of cardiopulmonary resuscitation: Ethical considerations. Nursing ethics, 26(1), 84-95. https://doi.org/10.1177/0969733017700234
Murphy, T. W., Cohen, S. A., Hwang, C. W., Avery, K. L., Balakrishnan, M. P., Balu, R., Chowdhury, M. A. B., Crabb, D. B., Elmelige, Y., Maciel, C. B., Gul, S. S., Han, F., Becker, T. K., & Interdisciplinary Cardiac Arrest Research Review (ICARE) group (2022). Cardiac arrest: An interdisciplinary scoping review of clinical literature from 2020. Journal of the American College of Emergency Physicians open, 3(4), e12773. https://doi.org/10.1002/emp2.12773
Penketh, J., & Nolan, J. P. (2022). In-hospital cardiac arrest: the state of the art. Critical care (London, England), 26(1), 376. https://doi.org/10.1186/s13054-022-04247-y
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)
Assignment 1: Lab Assignment: Ethical Concerns
Photo Credit: Getty Images/Maskot
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.
Ethics inform the care that nurses provide in their practice. The aim is to ensure safety and quality in addressing the patients’ care needs. Therefore, this paper explores the ethical concerns involved in caring for a 47-year-old man with ulcerative colitis who has no insurance. The patient has been admitted to the emergency room with extreme abdominal pain. He has not taken his medications for last few months and does not have any medical or prescription insurance.
Necessary Information
The additional information that should be obtained from the patient include symptom onset, duration, severity, precipitating, and relieving factors. Information on patient’s lifestyle such as alcohol use should also be obtained, as it can precipitate the disease. Physical assessment should identify if the patient is dehydrated or not, with diagnostic investigations such as complete blood count requested since the patient is at a risk of developing anemia.
Nursing Actions
Nurses and other healthcare providers act as advocates of their patients. They ensure the protection of their right to access high-quality, safe, and efficient care (Daly & Jackson, 2020; Molterer et al., 2020). Based on this, I would ensure the patient receives the care he needs despite lacking any medical or prescription insurance. Patients should not be discriminated in the care process based on factors such as ethnicity, race, or socioeconomic background.
Nurses should also demonstrate ethics in their practice. This includes ensuring the protection of principles such as informed consent, justice, beneficence, and non-maleficence. Therefore, an appropriate intervention in the case study would be protecting patient’s right to justice by providing the care that he needs. In addition, the nurse should alleviate any pain and suffering the patient has, hence, the principles of beneficence and non-maleficence (Mathibe-Neke, 2020; Moreau & Rudge, 2018).
Besides providing care the nurse should also collaborate with the social worker and link the patient with the existing insurance plans such as those in the Affordable Care Act plan. Such insurances will help the patient access the care he needs whenever he needs for ulcerative colitis. The nurse should also empower the patient about the effective management of his condition. This includes educating him about the causes, precipitating factors, and prevention (Butts & Rich, 2022; Grace & Uveges, 2022). The health education will help him take responsibility for his health. therefore, the consideration of the above interventions will promote ethics in the patient care process.
In summary, additional information and investigations should be performed on the client. Ethical principles should guide nursing actions. Patient empowerment should be considered. The aim should be relapse prevention for the patient’s optimum health and wellbeing.
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.
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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.
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Grading Criteria
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Week 11 Assignment Rubric
Check Your Assignment Draft for Authenticity
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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
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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
Rubric
NURS_6512_Week_11_Assignment_Rubric
NURS_6512_Week_11_Assignment_RubricCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeWrite 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).
35 to >29.0 pts
Excellent
The response clearly, accurately, and thoroughly explains detailed health assessment information required to diagnose the selected patient, with correct scenario number included.
29 to >23.0 pts
Good
The response accurately explains health assessment information required to diagnose the selected patient, with correct scenario number included.
23 to >17.0 pts
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