DISCUSSION: NURS 6512 Week 11 Ethical Concerns

What’s Happening in This Module?

Module 4: Ethics in Assessments is a 1-week module, Week 11 of the course and the last module in which you examine evidence-based practice guidelines and ethical considerations factor into health assessments.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7, Week 11
Lab Assignment: Ethical Concerns	Submit by Day 6 of Week 11.
Final Exam	Complete and Submit By Day 7 of Week 11.

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Go to the Module’s Content

Week 11

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

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_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)

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)

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. NURS 6512 Week 11 DQ: Ethical Concerns

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 NURS 6512 Week 11 DQ: Ethical Concerns:

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.

By Day 3

Post the explanation of the health assessment information required for a diagnosis of your selected patients (include the scenario numbers). 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. NURS 6512 Week 11 DQ: Ethical Concerns

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different scenarios than you, using one or more of the following approaches:

Suggest additional health assessment information that would be necessary to collect from the patient
Critique your colleague’s response, and explain alternative approaches to the situation.
Validate an idea with your own experience and additional research. NURS 6512 Week 11 DQ: Ethical Concerns.

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NURS 6512 Week 11 Quiz

Question 1

When interviewing a disabled patient, it is best to speak to:

Question 2

Which of the following is most likely to enhance examiner reliability?

Question 3

Throughout the history and physical examination, the clinician should:

Question 4

At your first meeting with a patient, it is usually best to say:

Question 5

Which of the following is true regarding the relationship between the examiner and the patient?

Question 6

When conducting a geriatric assessment, basic activities of daily living (ADLs) include:

Question 7

Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her:

Question 8

The reliability of health-related findings and observations is the responsibility of the:

Question 9

The cranial nerves are usually assessed while the patient is in which position?

Question 10

The best way to ease the apprehension of a 3-year-old child before a physical examination is to:

Question 11

When you attempt to move a 10-month-old child from his mother s lap to the examination table, he screams loudly. Your best action is to:

Question 12

Palpation of epitrochlear nodes is part of the:.

Question 13

Which medical condition would exclude one from sports participation?

Question 14

The greatest risk for potential health problems occurs in which age group?

Question 15

Functional assessment is most important during the examination of a(n):

Question 16

When conveying bad or distasteful news to the patient and family, it is best to:

Question 17

The checkout station for preparticipation physical evaluation (PPE) is critical because at this point:

Question 18

To promote your examination time with a cooperative child, your approach to the examination should be to:

Question 19

Which of the following data are not part of your general inspection?

Question 20

Part of the screening orthopedic component of the examination includes evaluating the person