NURS 6512 Week 11 The Ethics Behind Assessment

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

Learning Resources

  • 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.
  • 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)

The Ethics Behind Assessment Sample Paper

Health Assessment Information and Diagnosis

The information to aid in diagnosis will be based on subjective and objective data. The subjective data from the husband will include the signs and symptoms, allergies, medications the patient is taking, last meal, past medical history, including hypertension, and the events that would have precipitated the attack. I will probe the signs and symptoms like breathlessness, chest pain, and palpitation. 

Assessment of nutrition and risks of the patient will involve the last meal, alcohol drinking, cigarette smoking, and consumption of a fatty diet with a history of immobilization. Probing for a history of cardiac arrest in the family, stress, and frequency of exercise will help in diagnosis (Carberry et al., 2017). The objective data will include a physical exam and laboratory tests.

In the physical exam, I will focus on chest examination for tenderness, heart murmurs, pulse assessment, weight and height measurement to rule out obesity, and assessment for wheezing and chest expansion. The laboratory tests should include an electrocardiogram, chest x-ray to check heart size, nuclear scan, and coronary catheterization (McKernon et al., 2017). However, in an emergency setting, I would specifically use electrocardiography to direct my further interventions. 

ECG would detect ventricular and atrial rhythmic changes that would determine the use of defibrillation (Stankovic et al., 2020). The history, physical exam, and laboratory test confirm the diagnosis of cardiac arrest then management will be aimed at relieving the patient’s symptoms.

Response to the scenario

The response to the scenario will involve primary care at the emergency and long-term care. Emergency care will be provided while assessing the patient and doing further tests to confirm the diagnosis. Emergency primary care includes the assessment of the airway, breathing, circulation, and disability. I will immediately do defibrillation and cardiopulmonary resuscitation (CPR) to resuscitate the patient. 

Oxygen will be given in case the oxygen saturation levels go below 90%. Medications such as aspirin will be used to dissolve the clots (Soar et al., n.d.). Long-term management will include treating any underlying heart condition, encouraging exercise, cessation of smoking, reducing weight, providing beta-blockers and aspirin for long-term benefit. The family members will be reassured and encouraged to take the patient for a routine check-up to aid in palliative care. 

References

Stankovic, N., Høybye, M., Lind, P. C., Holmberg, M., & Andersen, L. W. (2020). Socioeconomic status and in-hospital cardiac arrest: A systematic review. Resuscitation Plus, 3(100016), 100016. https://doi.org/10.1016/j.resplu.2020.100016