NURS 6512 Week 11: The Ethics Behind Assessment
Sample Answer for NURS 6512 Week 11: The Ethics Behind Assessment Included After Question
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 health care 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
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Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
- Chapter 23, “Sports Participation Evaluation” (pp. 581-593)
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 24, “Putting It All Together” (pp. 594-609)
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.
- Review of Chapter 16, “Breasts and Axillae” (pp. 350-369)
- Review of Chapter 18, “Female Genitalia” (pp. 416-465)
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
- Chapter 12, “Discharging Patients from the Hospital” (pp. 285-293)
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.
Retrieved from the Walden Library Databases.
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 Retrieved from the Walden Library Databases.
Assignment: Ethical Concerns
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 Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.
Scenario 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.
Scenario 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.
Scenario 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.
Scenario 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.
Scenario 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.
Scenario 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.
Scenario 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.
To prepare:
- Select one scenarios, 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.
To complete:
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 3 different references from current evidence based literature.
By Day 6
This assignment is due.
Submission and Grading Information
Grading Criteria
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
Week 11 Final Exam
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 two hours for completion. When time is up, your exam will automatically submit.
By Day 7
Complete the Final Exam.
Submission and Grading Information
Submit Your Quiz by Day 7
A Sample Answer For the Assignment: NURS 6512 Week 11: The Ethics Behind Assessment
Title: NURS 6512 Week 11: The Ethics Behind Assessment
Scenario One – Vaccination Refusal
Working in the healthcare industry require clinicians to be culturally sensitive and culturally competent. Clinicians must be able to provide care to a wide variety of patients with believes, values and morals that may differ from what is considered to be the norm. This is differently the case in scenario one where the parents are a 5-year-old is refusing vaccination of their son prior to the staring of kindergarten. The student would first response to the scenario by asking the parents several questions, which include; why they are objecting to their son receiving the vaccines? If the child had previously received any vaccines? What were their concerns about the vaccines? Were the refusing the vaccines due to religiously believes? Do they have insurance? Where were they currently living? Based on the response to these questions that clinician would know how to proceed with the assessment. According to (Hendrix, Sturm, Zimet and Meslin, 2016) there are various reasons such as religious believes, lack of trust and believe in science or due to being influenced by others. Hendrix et al., (2016) further stated that may resist their children being vaccinated because of financial reason and while vaccinations are appropriate for other children it not for their children because their children are not vulnerable to illness. Some parents might agree with certain vaccines but not others according to (Hendrix et al., 2016). As a Clinician, I would educate the parents about how their choice of not having their son vaccinated against certain illness might not only be placing only child health at risk but also the health of other children. The question that is oftentimes asked is if parents who refused to have their kids vaccinated should be held in account for when their decision does not get their children to place the health risk of other children in jeopardy (Hendrix et al., 2016). There is a thin line between respecting the parent’s rights to refuse vaccines and that of the greater good.
To further support this notion of educating parents about having their children vaccinated, (Diekema, and the Academy of Pediatrics, AAP, 2019) from the Academy of Pediatrics (AAP) Committee on Bioethics stated that the role of clinician provides the parents with what are the risk and benefits of vaccines in order to make a well- informed decision. The (Diekema and the AAP, 2019) further stated that clinicians should also try to correct any wrong notion and information that parents have regarding vaccinations. Clinicians should also be willing to address and listen to any concerns that parents are having regarding their children being vaccinated. Per the ( Diekema and AAP, 2019) if parents continue to refuse after clinician address all parental concerns, then the wishes of the parents must be honored unless the child is a great risk of harm of contacting an illness in case of an epidemic. This is when other parties need to get involved because now the child being denies medical treatment by the parents in the middle of an outbreak ( Diekema, AAP, 2019).
There is the other side of the discussion that state that parents who refused to vaccinate their children, therefore putting other children at risks should be held liable. In respecting the parent’s autonomy not to vaccinate the child, even after educating the parents. The clinician must decide if he or she is going to continue to provide care to the child whose parents are refusing to have him vaccinated. The reason behind this ethical question is that if the clinician continues to provide care to the unvaccinated child may also be placing the health and well being of some of the clinician most vulnerable patients who are not old enough to receive certain vaccines. According to (Opel, Feemster, Omer, Orenstein, Richter and Lantos, 2014) “ pediatrician also has a responsibility to the other children in his or her practice who would be at risk of exposure if this unvaccinated infant develops a vaccine-preventable disease”. According to (Opel et al., 2014) this issue can be resolved if the clinician arranges where the unvaccinated and vaccinated patients are not in the same room together at the same time.
The decision that the clinician is faced within scenario one can be challenging and complicated, but the clinician must practice culturally sensitive and culturally competent care in order to deal with the situation in an ethical manner. Careful assessment must be done by asking several pertinent questions to determine why the parents are refusing to have their child currently vaccinated. Without careful assessment then there can’t be a formulation of an accurate treatment plan. There needs to be a further collection of subjective and objective data prior to any decisions being made regarding how to proceed with educated the patient’s parents about the importance of vaccinations in the prevention of certain illness.
References
Diekema, S. D, and Academy of Pediatrics (2019). Responding to parental refusals of
immunization of children. Retrieved from http://pediatrics.aappublications.org/content/115/5/1428.long
Hendrix, K. S., Sturm, L. A., Zimet, G. D., & Meslin, E. M. (2016). Ethics and Childhood
Vaccination Policy in the United States. American journal of public health, 106(2), 273-8.
Opel, J.D., Feemster, A. K., Omer, B. S., Orenstein, A. W., Richter, M. and Lantos, D. J.(2014).
A -month old with vaccine-hesitant parents. Pediatrics 133 (3). doi: 10.1542/peds.2013-2723
A Sample Answer 2 For the Assignment: NURS 6512 Week 11: The Ethics Behind Assessment
Title: NURS 6512 Week 11: The Ethics Behind Assessment
Case Study 5
Ethical considerations are mandatory requirements in health assessment, management and feedback to patients and their relatives. A 17-year-old boy who has come for a health checkup after head injury requires the presence of the parent or guardian for consent and ascent. Every human being has a right to timely, quality and adequate health assessment and care (Atkins, 2018). The purpose of this paper is to help advance nurse practitioners to offer health services with utmost professionalism and uniformity.
Health assessment information helps in identifying the etiology and making a diagnosis. The information required is the identification data of the patient. The presenting complainT is the head injury sustained in a football game. The next important information is the history of the presenting complainT (Dar, 2018). What lead to the injury, did the boy experience some loss of consciousness? Did he have a convulsion after the injury? How long has it taken for them to seek medical care? I will assess any injuries to the back, spinal cord and the pelvic region (Braunack-Mayer, 2017).
The advanced nurse practitioner has to make a physical assessment and determine the state of the boy. General appearance, orientation or any form of confusion. The nurse has to assess for any form of injuries to the head or any part of the body. Moreover, a laboratory analysis of blood to get the complete blood count is helpful in identifying the level of blood components. A head CT scan should be conducted to determine if the baby experienced brain injury, bleed of infarct (Carg, 2017)
The major priority of service providers is to ensure patients are safe, no harm, therefore, non-maleficence. Head injury is a trauma to the head that may result into an altered mental status. Severe cases can lead to intracranial bleeding and loss of consciousness. The scenario may plunge increased intracranial pressure and reduced blood flow into brain. (Lim, & Foust, 2020).
Management and response to the situation should be evidence based and true. Head injury is the most common presentation for admission in the emergency department. It is classified under mild, moderate and severe. I will keep the friends and relatives updated. Keep the patient still, head slightly elevated. Do not move the head of the patient but must assess kidney injury (Braunack-Mayer, 2017). The boy will be monitored for 24 hours and report. Communication to the family to avoid immediate anxiety. Unfortunately, I will communicate to the patient the need to avoid playing until he attains full recover
References
Atkins, S. (2018). Ethical and health and safety issues. Performance Assessment in Strength and Conditioning, 5-12. https://doi.org/10.4324/9781315222813-2
Braunack-Mayer, A. (2017). Health technology assessment: Ethical, legal and social issues. International Encyclopedia of Public Health, 497-499. https://doi.org/10.1016/b978-0-12-803678-5.00196-x
Dar, N. (2018). Shot gun injuries of the head and maxillofacial region in children and young adults: Clinico-epidemiological profile. Journal of Medical Science And clinical Research, 6(5). https://doi.org/10.18535/jmscr/v6i5.86
Garg, D. P. (2017). Visual evoked responses (VERS) in assessment of optic nerve injury in head injury patients. journal of medical science and clinical research, 5(7). https://doi.org/10.18535/jmscr/v5i7.178
Lim, F., & Foust, J. B. (2020). Transitional care. Evidence-Based Geriatric Nursing Protocols for Best Practice. https://doi.org/10.1891/9780826188267.0042