Nursing 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 Discussion, 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 three 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.

Questions to be addressed in my paper:

1. The explanation of the health assessment information required for a diagnosis of your selected patients (include the scenario numbers).

2. Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your responses.

3. Summary with Conclusion

REMINDERS:

1) 2-3 pages (addressing the 3 questions above excluding the title page and reference page).
2) Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016. Please utilize the references at least three below as much as possible and the rest from yours.
3) Make headings for each question.

RESOURCES:

· 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.
o 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.

o 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.

o Review of Chapter 16, "Breasts and Axillae" (pp. 350-369)
o Review of Chapter 18, "Female Genitalia" (pp. 416-465)

· Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

o Chapter 6, "Outpatient Charting and Communications" ("Advanced Directives"; pp. 128-129)
o Chapter 9, "Discharging Patients from the Hospital" (pp. 189-207)

· Burger, I. M., & Kass, N. E. (2009). Screening in the dark: Ethical considerations of providing screening tests to individuals when evidence is insufficient to support screening populations. American Journal of Bioethics, 9(4), 3-14.

Retrieved from the Walden Library databases.

This article recommends how physicians should respond when new screening examinations emerge in the marketplace. The authors examine how evidence influences decision making for screening.

· De Jong, A., Dondorp, W. J., de Die-Smulders, C. E., Frints, S. G. M., & de Wert, G. M. (2010). Non-invasive prenatal testing: Ethical issues explored. European Journal of Human Genetics, 18(3), 272-277.

Retrieved from the Walden Library databases.

The authors of this article examine the ethical consequences of non-invasive prenatal diagnostic tests. Specifically, the article describes the effects the tests may have on abortions.

· Rourke, L., Leduc, D., Constantin, E., Carsley, S., & Rourke, J. (2010). Update on well-baby and well-child care from 0 to 5 years: What's new in the Rourke Baby Record? Canadian Family Physician,56(12), 1285-1290.

Retrieved from the Walden Library databases.

In this article, the authors supply an overview of and evaluate the quality of evidence in the 2009 Rourke Baby Record.

· Womack, J. (2010). Give your sports physicals a performance boost. The Journal of Family Practice,59(8), 437-444.

Retrieved from the Walden Library databases.

This article explains how to conduct a thorough medical history and targeted physical exam. The article revolves around the use of the 4th edition of the Preparticipation Physical Evaluation.

· American Academy of Pediatrics. (2008). Recommendations for preventative pediatric health care (periodicity schedule).

Retrieved from http://www.aap.org/en-us/professional-resources/practice-support/financing-and-payment/Documents/Recommendations_Preventive_Pediatric_Health_Care.pdf

This resource provides recommendations for preventative pediatric health care 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. (2011). Rourke Baby Record. Retrieved fromhttp://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.