Category: Nursing

MN 580 Pediatric Client with Acute Bacterial Sinusitis

Pediatric Client with Acute Bacterial Sinusitis

 

List the clinical criteria that must be present to support this diagnosis in pediatric patients from newborn to 21 years of age. Categorize clinical signs and symptoms by: Persistent Symptoms, Severe Onset, or Worsening Symptoms.

 

List Criteria for Persistent Symptoms.

 

List Criteria for Severe Onset of Symptoms.

Severe

 

List Criteria for Worsening Symptoms

 

 

 

 

 When would imaging studies be indicated?

 

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What is the recommended Antibiotic for Child with No Known Allergies?

Provide dose, frequency, mg., ml., length of treatment, number of dosing units (i.e. prescription information).

 

MN 580 Pediatric Client with Acute Bacterial Sinusitis

What is the second line Recommended Antibiotic for Child with allergy to PCN

Provide dose, frequency, mg., ml., length of treatment, number of dosing units (i.e. prescription information).

 

When is Referral indicated?

 

What additional medications and or treatment strategies are recommended for treatment or symptomatic control

 

What is the treatment change in a child with worsening symptoms at 72 hours after initiation of antibiotic

 

When is outpatient 72 hour “observation” acceptable?

 

What modifications would be needed for the following children:

Four year old who is otherwise healthy

MN 580 Pediatric Client with Acute Bacterial Sinusitis

 

Child with immune deficiency

 

Child with two prior sinus infections

 

Child with cystic fibrosis

 

What other conditions would modify these treatment recommendations?

 

MN 580 Pediatric Client with Acute Bacterial Sinusitis

PICOT Question – air pollution in the elderly

 

P: air pollution in the elderly

 

I: exposure to air pollutant rates

 

C: population breathing risks

 

O: risk for respiratory illness or complications

 

T: 1 year

 

Intervention

 

In elderly population of Ironridge community (P), how does exposure to large amount of air pollution (I) compared to small amount of air pollution (C) affect risks and incidence of respiratory illnesses and complications (O) within one year (T)?

 

Prognosis/Prediction

 

In elderly population of Ironridge community (P), how does large amount of air pollution (I) compared to small amount of air pollution (C) influence/predict the incidence or risks of respiratory illnesses and complications (O) over a period of one year (T)? PICOT Question – air pollution in the elderly.

 

Diagnosis or Diagnostic Test

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In elderly population of Ironridge community (P) is large amount of air pollution (I) compared with small amount of air pollution (C) more accurate in diagnosing the incidence and/or risks of respiratory illnesses or complications (O)?

 

Etiology

 

Is elderly population of Ironridge community (P), who live with large amount of air pollution (I) compared with those living in small amount of air pollution (C) at risk of acquiring respiratory illnesses or complications (O) over a period of one year (T)? PICOT Question – air pollution in the elderly.

 

Meaning

 

How do elderly population of Ironridge community (P) with large amount of air pollution (I) perceive risks of respiratory illnesses or complications (O) during one year (T)?

 

The format of PICOT question (Population, Intervention, Comparison, Outcome and Time) is an effective and consistent approach to development of logically sound, answerable and researchable questions. The PICOT question that was developed is of an intervention type (Boswell, Boswell & Cannon, 2014). This type of question is especially effective when certain data has to be acquired while simultaneously paying attention to different perspectives and the final outcome. In order to proceed with this particular PICOT question a prescriptive research approach should be carried out (Echevarria & Walker, 2014). This question is developed in a way that already provides clues for further research. Nevertheless, acquiring the data in conjunction for the subjects may yield some new points of perspective and help to find out a complex solution that would address the problem with the maximum positive outcome. According to the plural nature of the population mentioned above Intervention and Comparison part of the question may also be viewed separately or co-jointly. The outcome of the problem in question, however, is somewhat similar incidence or risks of occurrence of respiratory illnesses or complications among populations. The last part of the PICOT question the Time component is  one year, to equate the data. PICOT Question – air pollution in the elderly.

16 year old adolescent case study

As a family nurse practitioner you are working in a rural health clinic. You are evaluating a 16-year-old adolescent patient who comes in complaining of having a difficulty concentrating in school. On exam you also note that the patient is very thin and frail in appearance and is asking you for diet pills.

What are some initial areas for concern? What screening tools can help lead you closer to your diagnosis?

Describe 1 health promotion strategy you can discuss with the patient.

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Be sure to address the following in your plan of care: pharmacological and non-pharmacological (OTC) interventions, labs, follow-up, teaching, and referral/s. 16 year old adolescent case study.

Your work should integrate course resources (text/s) as well as a minimum of two (2) other evidence-based guidelines and/or articles published within 3-5 years.

Reference:

Centers for Disease Control and Prevention. (2013). Youth risk behavior surveillance

system (YRBSS). Retrieved from http://www.cdc.gov/healthyyouth/data/yrbs/index.htm 16 year old adolescent case study

Refinement of Nursing Issue into Research

Evidence-based practice promotes change with evidence every day.  Once upon a time, practice was done using trial and error.  The evidence on an action’s effectiveness or ineffectiveness would therefore promote the use or discontinued use.

The role of research within evidence-based practice (EBP) is vital to the validity of the evidence.  Bourke and Loveridge (2013) explain that evidence-based practice requires obtaining the best available external clinical evidence and incorporating it for evaluation against systematic collections of data received from research.  Research is influenced by evidence-based practice so that the content has greater value. Refinement of Nursing Issue into Research.  This value comes from knowing that the information provided within the literature you view has been substantiated by other experts in the given field.  The researcher evaluates the findings provided in a study, qualifying the study as scholarly.  To qualify as scholarly, the author of the study will submit their credentials of how or why they should be considered as a qualified author on the subject.  In addition, the author will submit their written findings to other peers in the field for their review of the research material.  This is called a peer review study and after being reviewed and accepted by the author’s peers, this helps to ensure to the reader of the literature that other experts in the pertaining field have reviewed the study material and concur with what is written.  This is what allows the research to be considered evidence-based instead of conjecture or a hypothesis.

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This paper addresses the issue of health care literacy.  According to MacLeod et al. (2017), research shows that inadequate health literacy impacts total patient-centered care; it affects compliance with healthcare, recommended preventative services, utilization of healthcare, medical expenditures and overall care.

The desperate need for increased exposure to health literacy is of grave importance.  Individuals with inadequate health literacy typically have poorer mental and physical health as well as being sicker in general (MacLeod et al., 2017).  This is because these individuals are lacking education on the importance of understanding how to identify evidence-based information and the importance of why and how this information can and will affect their overall health conditions.  Without the attention this issue deserves, the population of individuals with deficient health literacy will only continue to grow and more people will suffer from poor decision making and lack of action related to health care. Refinement of Nursing Issue into Research.

Application to Selected MSN Program Specialty Track

There is an expectation as an advance practice nurse to provide care based on the best possible evidence available.  Using the best available evidence is not enough to ensure confidence as a provider.  Master’s-prepared Family Nurse Practitioners must also demonstrate genuine concern regarding patients’ health and healthcare outcomes.  Establishing a connection with the patient and their ability to access and understand information and use of technology must also be accomplished (Harris, Thomas, & Fox, 2015).

The impact of resolving healthcare literacy would allow the Family Nurse Practitioner to connect with their patient at a greater level of comprehension.  The Master’s-prepared Family Nurse Practitioner must have greater confidence in the ability of the patient to stay compliant, and, when needed ask appropriate questions to be a more active partner in their own healthcare delivery.

The improvement of health literacy improves overall health conditions and reduces the cost of care.  Haun et al. (2015) provide extensive research stating that health literacy is a major contributor to the higher costs associated with medical care, and increased level of severity of both acute and chronic conditions. Refinement of Nursing Issue into Research.

Nursing Issue and Supportive Evidence Regarding the Issue

Media presents the general audience with all types of remedies through advertising from pharmaceutical manufacturers to products that are supposed to make someone healthier.  Whether the viewer is seeing advertisements on television, as a pop-up advertisement, or conducting a search on symptoms they may be experiencing, they are able to locate advertising to support what they are looking for.  With all the advancements in technology these days the consumer can obtain information from the internet simply by using hand-held devices such as cell phones and tablets, computers, and wireless two-way smart speakers, and now televisions even have internet capabilities built into them.  With information so accessible, it is critical to be able to decipher between credible and non-credible information.  Not having the right tools to do any job can be dangerous.  Not having the right tools to discriminate and recognize the best possible evidence, regarding healthcare can be lethal. Refinement of Nursing Issue into Research.

Patients frequently attempt to save time and money by looking up their physical ailments online to diagnose an issue they are experiencing.  Consumers then go to the store and purchase what they saw advertised or seek to buy it online.  The consumers believe they are saving money and feel good about caring for themselves.  Unfortunately, when the products consumers purchase fail to make them feel better or cure what they believe is their issue, they are then forced to either live with the condition hoping it goes away or seek attention from a health care provider.  This requires the patient to spend additional time and money, which could have been avoided had the consumer been knowledgeable about locating evidence-based information to help them help themselves.  Patients are not always forthcoming with notifying the provider of remedies attempted on their own.  Not notifying the provider of attempted remedies could cause the provider to miss pertinent data or information, improperly diagnose a condition, order additional unnecessary tests, and cost the patient a lot of extra money.

Patients who have a low health literacy may purchase over-the-counter supplements in hopes to help improve memory, fatigue, or stamina.  Not notifying the nurse or provider of these over-the-counter supplements could be the cause of an issue the patient is having.  Many individuals with low health literacy do not realize that over-the-counter supplements may be available without a prescription, but they still should not be taken without consultation from a health care provider.  The fact that supplements are available over-the-counter without a prescription does not make them safe for everyone.

In every health care setting it is the nurse’s responsibility to educate the patient. This becomes a difficult task when the patient is not responsive to learning and believes they can just go online and learn all they need to know. The prevalence of low health care literacy in society is at the highest level of all time (Johnson, 2014).  This may be because the largest growing population are older adults.  According to MacLeod et al. (2017), the number of people age 65 and over in the United States is over 46 million, and anticipated to more than double in the next 30 years.  Therefore, the mismatch between the health provider’s communication and the low health literacy of the patient adversely affect health outcomes daily (Johnson, 2014).

The proposed solution to help bridge the gap with health literacy in the community is to have nurses and medical librarians hold educational seminars free of charge.  Inviting the public to attend these seminars at local libraries, park-districts, and community centers will help educate consumers on the importance of health literacy.  Additionally, public service announcements would prove instrumental in explaining to consumers why the need to be educated on health literacy is so important.  Millican (2014) identifies creative ways in which collaborating with medical librarians and health organizations can minimize health literacy barriers.  This is because evidence-based practice originated with medical librarians teaching the importance of locating the best possible evidence to support health care delivery and how to identify which evidence qualified as the best possible evidence available.

Additional solutions for helping bridge the gap with health literacy include one-on-one consultations with patients in the health care clinic, or inviting patients to join group discussions regarding the importance of learning more about evidence-based health care.  Another potential option would be providing an online forum for patients to log into to read about questions other people are having that might affect them or their loved ones.  It is important to make available in generalized terms to the consumers that health care is delivered to them by health care providers who have done investigating into clinical trials and documented research, so that the health care practices that they give to the patient are done so by using the results of the research to make the best decisions on how to treat the patient the safest with the most optimal outcome.

The stakeholders impacted by low health literacy issues are the patients, patients’ loved ones, and health care providers.  MacLeod et al. (2017) recognized the individuals having inadequate health literacy are people of lower income levels, lesser education, minorities, and older males.  Empirical evidence explains individuals with low health literacy are at greater risk for making inappropriate decisions regarding their own personal health in addition to decisions for their loved ones (Engelke, 2016).  Inappropriate decision making can severely affect the stakeholder’s current and future health condition, by not getting health care attention soon enough, by not being compliant with directions given by the nurse or provider, and not understanding the ramifications of what might result in a chosen action.

By implementing this evidence-based practice project expected outcomes are to be improved compliance with provider direction, increased and improved patient satisfaction, and a greater sense of comfort for the patient. Refinement of Nursing Issue into Research. By improving patient health literacy, it allows patients to make educated decisions for themselves and their loved ones.  Educated decision making in lieu of arbitrary decisions based on advertisement coercion or lack of evidence to support the decision-making process improves patient care by allowing or seeking the best possible interventions made for the patient.  This in turn saves the patient time, money and gives them a greater sense of autonomy, strengthening the patient both mentally and physically.  Additionally, the Master’s-prepared Family Nurse Practitioner, in combining efforts along with health science librarians, will strengthen their ability to continue to provide evidence-based practice to their patients.  As Eldredge (2016) states, the use of the best evidence allows health science librarians to advance evidence-based practice along with healthcare providers. This keeps the health care providers on top of new or recent changes to evidence and sourcing of reliable data.  Having the ability to gather the best evidence available keeps patients safer and better cared for, making it possible to decrease health care costs and time providers need to spend with each patient.  If providers are not having to spend extensive time with patients, more patients can be seen, and a larger population cared for.

Evidence-based Practice Question

The PICOT format is used to address the question: In patients in the community center receiving care, does providing education on health literacy influence finding credible information regarding healthcare as compared to not receiving education on health literacy?  This question will be answered by surveying the people in the community health center, prior to the teaching intervention, and then again 6 months following the education intervention the same members of the community health center will be surveyed to give us our pretest and post-test data figures.  We use the optional (T) in the PICO because we are conducting a quantitative approach. Refinement of Nursing Issue into Research.

P:   Patients in the community center

I:    Providing literacy education one-on-one and/or in a group setting

C:   Patients with health literacy education compared to patients without health literacy education

O: The ability for patients to locate credible information with and without health literacy education.

T:   Surveying the population prior to the teaching intervention and 6 months after the teaching.

Conclusion

Health literacy is a major issue affecting the health and wellbeing of many Americans.  According to Rong et al. (2017), the ability to gather and comprehend basic information regarding health care and to make informed, educated decisions based on that comprehension describes health literacy.  Engelke (2016) teaches that consumers with a low health literacy are at greater risk for poor decision making related to healthcare options.

Interventions are available to help educate people on what information is credible and how to discern between credible evidence-based information and non-credible information.  Eldredge (2016) explains how evidence-based practice was created by medical scientific librarians who taught health care providers how to research and use the best possible evidence to direct patient centered care.  Logically, it then serves to reason that, the same professional body should be involved in educating the public on evidence-based practice and how to encompass it into improving health literacy.

In writing this assignment I learned that there are many factors that help to create and support low health literacy.  I had a preconceived idea or concept of what I felt health literacy encompassed.  In completing research on this topic, I have learned that there is far more than I ever imagined involved with health literacy.  One of the more surprising things that I learned was that the convergence to evidence-based practice into the clinical setting originated from the medical librarians, their creation of a system where the research and literature providing the evidence to learn and practice from allowed practitioners to learn and provide care based on that best available evidence.  Additionally, this assignment caused me to give extensive thought to the government, and their use of mass promotion on public safety issues such as the opioid crisis.   A major contributor to this crisis is evidenced by low health literacy.  Health literacy can address the senseless deaths opioid use is causing, by educating consumers on why so many over-doses are killing people.  I feel it’s very possible to reduce the number of deaths, by simply educating the public.  The old proverb “Knowledge is Power” speaks volumes to correcting and abolishing many health issues, as many are self-created due to low health literacy. Refinement of Nursing Issue into Research.

 

References

Bourke, R., & Loveridge, J. (2013). A scientist-practitioner model for inclusive education: Supporting graduate students to conduct systematic reviews for evidence-based practice. 
New Zealand Journal of Teachers’ Work
, 
10
(1), 4-23.

Eldredge, J. D. (2016). Integrating research into practice. 
Journal of The Medical Library Association
, 
104
(4), 333-337. doi:10.3163/1536-5050.104.4.017

Engelke, Z. M. (2016). Patient Education: Caring for patients with low health literacy. 
CINAHL Nursing Guide
.

Harris, L., Thomas, V., & Fox, M. (2015). The influence of health care literacy on the use of PHRs among older adults. 
MEDSURG Nursing
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24
(4), 283-285. Refinement of Nursing Issue into Research.

Haun, J. N., Patel, N. R., French, D. D., Campbell, R. R., Bradham, D. D., & Lapcevic, W. A. (2015). Association between health literacy and medical care costs in an integrated healthcare system: A regional population based study. 
BMC Health Services Research
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15
(1), 1-11. doi:10.1186/s12913-015-0887-z

Johnson, A. (2014). Health literacy, does it make a difference? 
Australian Journal of Advanced Nursing
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31
(3), 39-45.

MacLeod, S., Musich, S., Gulyas, S., Cheng, Y., Tkatch, R., Cempellin, D., & … Yeh, C. S. (2017). Feature article: The impact of inadequate health literacy on patient satisfaction, healthcare utilization, and expenditures among older adults. 
Geriatric Nursing
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38
(4), 334-341. doi:10.1016/j.gerinurse.2016.12.003

Millican, K. (2014). How are medical librarians addressing health literacy barriers? 
Serials Librarian
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67
(3), 260-275. doi:10.1080/0361526X.2014.915606

Rong, H., Cheng, X., Garcia, J. M., Zhang, L., Lu, L., Fang, J., & … Chen, J. (2017). Survey of health literacy level and related influencing factors in military college students in Chongqing, China: A cross-sectional analysis. 
Plos One
, 
12
(5), e0177776. doi:10.1371/journal.pone.0177776. Refinement of Nursing Issue into Research.

Compare rates of obesity in the United States to other developed and also developing countries in an Obesity Epidemic Essay. Think about how health issues resulting from obesity compare as well.

Reflect on health promotion and prevention strategies that nurses can implement.

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Contemplate the ethical, cultural, economic, political, and environmental issues a nurse should consider when developing a primary obesity health prevention strategy.

Post an obesity health promotion and prevention strategy a nurse could implement for a specific cultural group in the United States. Then, modify your message for use in one other country, being sensitive to the cultural nuances of the country you select. Describe why you chose to take the approach you did in your strategies and explain any challenges you anticipate a nurse may encounter when trying to implement these strategies Obesity Epidemic Essay.

NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay

Introduction

A versatile reaction or adaptive responses is a compensatory component of the body’s appropriate response to a natural request, (Hammer & McPhee, 2014).  The body creates different versatile reactions to manage specific outside intruders. The body can shape the reaction in a way that its reaction to different assaults, body damage or simply body depletion. The pathophysiology, associated alterations, and the patients ‘adaptive responses to the changes caused by the disease processes determined from the given three scenarios will be explained. From the three given scenarios, a diagnosis of Viral Tonsillitis is made from scenario1, diagnosis of Irritant Contact Dermatitis is made from scenario2 and diagnosis of Stress Response is made from scenario 3. Additionally, a mind mad of Viral Tonsillitis will be made, and it will incorporate the study of disease transmission, pathophysiology, chance elements, clinical introduction, and diagnosis of Viral Tonsillitis, and also any versatile reactions to modifications. NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.

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Scenario Number One

Jennifer is a 2y/o old female who presents with her mom. Mother is concerned that Jennifer has been “running a temperature” for 3 days now. Mother says that Jennifer is generally strong and has no medicinal history. The symptoms Mom said Jennifer has been having are: Fever (Temperature of 103.2oF), she is fussy and would not eat. Also upon A physical examination uncovers that the Patient(Jenifer) who shows up intensely unwell. Her skin is hot and dry which indicate fever. The tympanic films are marginally blushed on the outskirts, however generally typical in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates, Lymph nodes are palpable and clearly tender to touch on the left side. Jennifer said her throat hurts especially when she swallows.  Vital Signs uncover a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute. NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay. From the above chief complaints and symptoms that Jennifer presents with, a diagnosis of Viral tonsillitis will be made. Signs and symptoms of viral tonsillitis are: sore throat, pain on swallowing, erythema and/or edema of the tonsils, and enlarged or tender tonsillar and cervical lymph nodes (Malapane, Solomon, Pellow, 2014). Jennifer’s throat was red, pain when she swallows and palpable lymph nodes. NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.

Pathophysiology of Tonsillitis

Viral Tonsillitis is inflammation of the tonsillar tissues; most cases are of viral origin, with the adenovirus, rhinovirus, coronavirus, or respiratory syncytial virus being most commonly implicated. Around fifteen percent to thirty percent cases are caused by bacterial infections, of which group A b-hemolytic streptococcus is the most common in pediatric patients (Malapane, Solomon, Pellow, 2014). For Bacterial Tonsillitis to be determined, a throat culture will be sent to the lab for examination and if and when lab results show bacterial before the diagnosis can be made (Huether & McCance, 2017). Which then will be treated with antibiotics. Tonsillitis commonly occurs in children, the average incidence of all viral respiratory tract infections is five to seven episodes a year per child, and tonsillopharyngitis of all varieties constitutes about 15% of visits to primary care physicians (Malapane, Solomon, Pellow, 2014). The inflammation of the tonsillar, swelling of the lymph nodes, erythema, and fever are versatile reactions to the disorder. (Huether and McCance, 2017). Tonsillar contaminations (tonsillitis) are at times sufficiently extreme to cause upper aviation route hindrance. The frequency of tonsillitis optional to aggregate A beta-hemolytic Streptococus (GABHS) and methicillin-safe Staphylococcus aureus (MRSA) has ascended in the previous 15 years (Huether and McCance, 2017). Upper aviation route block on account of tonsillitis is an outstanding inconvenience of irresistible, particularly in a youthful tyke. Tonsiller perhaps entangled by arrangement of a tonsillar ulcer, which can additionally add to aviation route check. (Huether and McCance, 2017) NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay. Peritonsiller abscess is typically one-sided and is regularly in a difficulty of intense tonsillitis.

Treatment for Tonsillitis

Bacterial tonsillitis is treated with antibiotic therapy, NSAIDs for pain and fever, rest and adequate fluid hydration, and Tonsillectomy only in advanced cases of the disorder. If the cause is a virus infection, there is no medicine to treat it. But if the cause is a bacterial infection, such as strep throat, the use of antibiotics will be required. (Huether and McCance, 2017). NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.

Scenario Number Two

Jack is a 27-year-old, presents with redness and aggravation of his hands. He reports that he has never had an issue this way, yet around 2 weeks back he saw that the two his hands appeared to be extremely red and flaky, sometimes his hands feels hot and he does not know why. Patient has no known allergies and no medical history. He is a maintenance engineer in a newspaper building, He regularly works with grating solvents and synthetic compounds. Lately he has not been wearing protective gloves because their company is short in supply. Although he stated to washing off his hands once completed with his work. Due to his complaints and symptoms he presents, a diagnosis of irritant contact dermatitis is made. NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.
 

Pathophysiology of Irritant Contact Dermatitis

When skin comes in contact with cleaning chemicals, like the ones Jack uses at work, it will cause irritation to the skin causes damage to the epidermal cells and inflammation.  Inflammation is the second line of defense; presenting as redness, heat, swelling, pain, and sometimes loss of function (Huether & McCance, 2017).  Dermatitis is limited irritation of the skin. The aggravation contact dermatitis is the irritation that is caused when some substance found in the working environment come into coordinate contact with the skin. The normal signs will incorporate rankles, redness of the skin, and scales (Proksch & Brasch, 2012). These indications might not occur immediately it depends upon the individual’s skins and the type of chemicals exposed to. The symptoms reported by Jack are the redness and irritation of the hands show that the dermatitis was caused by a chemical that irritates (Proksch & Brasch, 2012). NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.
 

Scenario Number Three

Martha is a 65-year-old female, who is retired, has history of Hypertension (HTN) and she is currently taking hydrochlorothiazide to treat the HTN. She presents today with complaints of difficulty sleeping, “racing heartbeat,” and a loss of appetite. Patient is also currently caring for elderly ill mother, who totally depends on Martha for activities of daily living and everything else. From the above changes that occurred in Martha’s life and symptoms that she is having, a diagnosis of Stress Response is made for Martha NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.

 
Pathophysiology of Stress Response

Stress is a system of interdependent processes that are moderated by the nature, intensity, and duration of the stressor and the coping efficacy of the affected individual, all of which in turn mediate the psychologic and physiology response to stress. (Huether & McCance, 2017). Stress can be caused by significant life changes, an expected human response to challenging situations, like the loss of a job, loss of a family member, trauma, and abuse.” (Huether & McCance, 2017). Life change in Martha’s life is caring for her ailing 87 old mother who is recovery from hip replacement and totally depends on Martha for activities of daily living and with no help or relieve from anyone for Martha. Stress response is initiated when a stressor is present in the body or perceived by the mind.  Physiological stress may cause or worsen several disorders, including insomnia, fatigue chronic pain et cetera. (Huether & McCance, 2017) NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.  The release of epinephrine is enhancing myocardial contractility, causing Martha’s heart rate to increase. Glucocorticoids play and important role in the homeostasis of the CNS that regulates memory, cognition, mood and sleep (Huether & McCance, 2017). People response to stress differently, depending on the person’s perception of the stressor and the coping mechanism of the person. To Martha, Stress response must have been triggered by the increased burden of caring for her of her 87-year-old mother who need total assistance from her. These are unexpected circumstances, that were never planned for after her retirement. Stress includes difficulty sleeping and increased heartrate etc (Huether & McCance, 2017).  Martha also is exhibiting these symptoms based on her chief complaints. Adaptive coping strategies are those that focus on the problem and encourage social support resulting in the beneficial reduction in perceived stress (Huether & McCance, 2017).

Treatment for Stress Response

Stress can be managing in different ways and some of those treatment options for Martha are Relaxation techniques, Relaxed deep breathing, to help Martha calm down help with the increased heart rate. Promote socialization outside of caring for her Mom, support groups for individual experiencing comparative circumstances, counseling if possible and Cognitive behavioral therapy(CBT) is the treatment that has met with the most success in combating a stress disorder. CBT has two main components. First, it aims to change cognitions, or patterns of thought surrounding the traumatic incident. Second, it tries to alter behaviors in anxiety-provoking situations (Psychology Today,2018). Cognitive behavioral therapy not only ameliorates the symptoms of acute stress disorder but also attempts to prevent the development of post-traumatic stress disorder. (Psychology Today, 2018). NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.

 

 

References

(Zimbron, 2008)

Conclusion

The versatile responses will always be activated once the infection is present. The body defense mechanism and hence generating antigen. The adaptive response to stress includes insomnia, loss of appetite , which were observed in Martha’s case.  The adaptive response to cleaning-chemicals substance includes redness, swelling, and itchiness and the symptoms expressed in Jennifer, the 2y/o old are adaptive response of viral infection that causes the inflammation of the Tonsils. Having a good knowledge of the pathophysiology of  disorders and the body’s adaptive reactions to those disorders or diseases is very important  for the Advance Practice Nurses to properly, rightly diagnose and treat their patients with those diseases. NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay.

References

Huether, S. E., & McCance, K. L. (2017). Understanding Pathophysiology (6th ed.) St. Louis, MO: Mosby.

Hammer, G. G., & McPhee, S. (2014). Pathophysiology of

disease: An introduction to clinical medicine. (7th ed.) New York, NY:  McGraw-Hill Education.

Proksch, E., & Brasch, J. (2012). The abnormal epidermal barrier in the pathogenesis of contact dermatitis. Clinics in Dermatology, 30(3), 335-344.

National Institutes of Health, (2017). National Tonsillitis Also called: Tonsil Inflammation. Retrieved June 7, 2018 From https://medlineplus.gov/tonsillitis.html NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay

Eunice Malapane, Elizabeth M. Solomon, Janice Pellow, (2014, November 11). Efficacy of a Homeopathic Complex on Acute Viral Tonsillitis. Retreived June , 2018 From
https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=2&sid=11afee78-30e5-4cb4-83f3-afed2b83da35%40sessionmgr4010

Psychology Today, (2018). Cognitive Behavioral Therapy, Retrieved June 6, 2018. From
https://www.psychologytoday.com/us/therapy-types/cognitive-behavioral-therapy

Tonsillitis. (2016). American Academy of Otolaryngology Head and Neck Surgery Retrieved June 9, 2018, from
http://www.entnet.org/content/tonsillitis

Zimbron, J.  (2008). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from
http://www.medmaps.co.uk/beta/

Harvard University, (2018). Understanding the stress response, Retrieved June 7, 2018 From
https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
 NURS 6501 – Advanced Pathophysiology – Adaptive Response Essay

Professional Identity and Stawardship I

Interview a fellow peer in your class who works in a different health discipline than you. Begin your interview with the following questions:(note the answers to the interview have been provided

1.What is your role as a health care team member?

-I am the nurse specialist in the dialysis unit. I work with other disciplines in the unit to help keep our changing nursing practice current and relevant. Professional Identity and Stawardship.

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2.How do you define professionalism and how does professional responsibility influence your work?

-Professionalism can be defined as a person that presents with a set of skills and is able to skillfully perform his/her skills and also articulate the details of that particular skill set. My professional responsibilities enable me to keep current on the most current nursing practices.

3.Do you consider leaders in your organization stewards of health care? Why or Why not?

-Yes, I believe anyone can be a leader. We can all learn something new daily from our co-workers. We are all stewards of care.

4.Is it important to you that leaders exercise professional advocacy and authenticity as well as power and influence when working with colleagues? Why or why not?

-It is important that everyone, especially leaders display professional advocacy and authenticity. Leaders should be able to guide others without micro managing their staff.

In 500-750 words, summarize your interview and share your impressions of your peer’s responses.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required Professional Identity and Stawardship.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Only Word documents can be submitted to LopesWrite. Professional Identity and Stawardship.

RUBRIC

Criteria

Achievement Levels

Description

Percentage

Unsatisfactory 0-71%

0.00 %

Less Than Satisfactory 72-75%

75.00 %

Satisfactory 76-79%

79.00 %

Good 80-89%

89.00 %

Excellent 90-100%

100.00 %

Content

80.0

Detailed Summary of Peer Interview

80.0

Summary of peer interview is not provided or is incomplete.

Summary of peer review is unclear or inconsistent with professionalism and the role of stewardship.

Summary of peer review is clear, but one of the four components of the interview is lacking.

Summary of peer review is provided with detailed explanation of each component of professionalism, stewardship, advocacy, and authenticity. Professional Identity and Stawardship.

Comprehensive summary of peer review is provided with detailed explanations of each component of professional identity and a thoughtful discussion of the interviewer’s perceptions of the interview experience.

Organization and Effectiveness

15.0

Thesis Development and Purpose

5.0

Paper lacks any discernible overall purpose or organizing claim.

Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.

Thesis and/or main claim are apparent and appropriate to purpose.

Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose. Professional Identity and Stawardship.

Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

Paragraph Development and Transitions

5.0

Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed.

Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident. Professional Identity and Stawardship.

Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.

A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose.

There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5.0

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used Professional Identity and Stawardship.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

Format

5.0

Paper Format (Use of appropriate style for the major and assignment)

5.0

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct Professional Identity and Stawardship.

Total Percentage

100

Professional Identity and Stawardship II

Interview a person in a formal position of leadership within your organization (e.g., a supervisor, a manager, a director). Begin your interview with the following questions:(Note answers to interview question have been provided afer the question below)

1.What is your role as a health care team member?

-As a healthcare team member, I am responsible for working with the interdisciplinary team to coordinate patient care efficiently.

2.How do you define professionalism and how does professional responsibility influence your work?

-I define professionalism as practicing to your core values and the hospital Core Values. I align my values with the Medical center. ICARE Professional Identity and Stawardship

3.Do you consider yourself a steward of health care? Why or Why not?

-Yes, it is important that leaders exercise professional advocacy and authenticity as well as power and influence when working with colleagues. We are each other’s customers. It is very important to exhibit characteristics we want to convey the message of care, trust and expertise.

4.Is it important to you that leaders exercise professional advocacy and authenticity as well as power and influence when working with colleagues? Why or why not?

In 500-750 words, summarize your interview and share your impressions of the leader’s responses.

Compare and contrast responses provided by your peer (in Professional Identity and Stewardship – Part I: Peer Interview assignment) with those provided by the leader. Share your impressions of their differences and similarities.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite. Refer to the directions in the Student Success Center. Only Word documents can be submitted to LopesWrite. Professional Identity and Stawardship.

RBRIC:Criteria

Achievement Levels

Description

Percentage

Unsatisfactory 0-71%

0.00 %

Less Than Satisfactory 72-75%

75.00 %

Satisfactory 76-79%

79.00 %

Good 80-89%

89.00 %

Excellent 90-100%

100.00 %

Content

80.0

Detailed Summary of Leader Interview

70.0

Summary of leader interview is not provided or is incomplete.

Summary of leader review is unclear or inconsistent with professionalism and the role of stewardship.

Summary of leader interview is clear but one of the four components of the interview is lacking.

Summary of leader interview is provided with detailed explanation of each component of professionalism, stewardship, advocacy and authenticity. Professional Identity and Stawardship.

Comprehensive summary of leader interview is provided with detailed explanations of each component of professional identity and a thoughtful discussion of the interviewer’s perceptions of the interview experience.

Compares and contrasts the peer responses, from Professional Identify and Stewardship-Part 1, with those provided by the leader. Shares impression of differences and similarities.

10.0

No comparison and contrast of peer responses with those provided by the leader are provided.

Comparison and contrast of peer responses with those provided by the leader and student’s impression of those differences and similarities are not adequately addressed.

Comparison and contrast of peer responses with those provided by the leader and student’s impression of those differences and similarities meet the basic expectations of the assignment as indicated by the assignment instructions.

Comparison and contrast of peer responses with those provided by the leader and student’s impression of those differences and similarities demonstrate a clear understanding of roles, professionalism, stewardship, and advocacy as it applies to leadership Professional Identity and Stawardship.

Comparison and contrast of peer responses with those provided by the leader and student’s impression of those differences and similarities demonstrate a clear understanding of roles, professionalism, stewardship, and advocacy as it applies to leadership, while demonstrating higher level thinking as indicated by evidence of reflective thought.

Organization and Effectiveness

15.0

Thesis Development and Purpose

5.0

Paper lacks any discernible overall purpose or organizing claim.

Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.

Thesis and/or main claim are apparent and appropriate to purpose.

Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear. Professional Identity and Stawardship.

Paragraph Development and Transitions

5.0

Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed.

Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.

Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.

A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose.

There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5.0

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English. Professional Identity and Stawardship.

Format

5.0

Paper Format (Use of appropriate style for the major and assignment)

5.0

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

Total Percentage Professional Identity and Stawardship

Policy/Regulation Fact Sheet Assignment

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

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In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate. Policy/Regulation Fact Sheet Assignment.

To Prepare:

• Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.

• Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).

https://www.aanp.org/practice/practice-management/quality-improvement/macra-mips Policy/Regulation Fact Sheet Assignment.

 

• Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

• Briefly and generally explain the policy or regulation you selected.

• Address the impact of the policy or regulation you selected on system implementation.

• Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow. Policy/Regulation Fact Sheet Assignment.

• Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

8/5/2019 Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16569051_1&rubric_id=_1068954_1 1/3

Rubric Detail

Select Grid View or List View to change the rubric’s layout.

Excellent Good Fair Poor

Create a 1-page

fact sheet that

your healthcare

organization

could

hypothetically

use to explain

the health or

nursing

informatics

policy/regulation

you selected.

Your fact sheet

should address

the following:

· Briey and

generally explain

the policy or

regulation you

selected.

· Address the

impact of the

policy or

regulation you

selected on

system

implementation.

· Address the

impact of the

policy or

regulation you

selected on

clinical care,

patient/provider

77 (77%) – 85

(85%)

A fully

developed and

detailed Fact

Sheet is

provided for the

Assignment.

The responses

accurately and

thoroughly

explain in detail

the policy and

regulation

selected.

The responses

accurately and

thoroughly

explain in detail

the impact of

the policy or

regulation

selected on

system

implementation.

The responses

accurately and

thoroughly

explain in detail

the impact of

the policy or

regulation

selected on

clinical care,

patient/provider

interactions,

68 (68%) – 76

(76%)

A developed

Fact Sheet is

provided for the

Assignment.

The responses

explain the

policy or

regulation

selected.

The responses

explain the

impact of the

policy or

regulation

selected on

system

implementation.

The responses

explain the

impact of the

policy or

regulation

selected on

clinical care,

patient/provider

interactions,

and workow.

Accurate

responses

highlight the

organizational

policies and

procedures that

60 (60%) – 67

(67%)

A vague or

inaccurate Fact

Sheet is

provided for the

Assignment.

The responses

explaining the

policy or

regulation

selected are

vague or

inaccurate.

The responses

explaining the

impact of the

policy or

regulation

selected on

system

implementation

are vague or

inaccurate.

The responses

explaining the

impact of the

policy or

regulation

selected on

clinical care,

patient/provider

interactions,

and workow

are vague or

inaccurate.

0 (0%) – 59 (59%)

A vague and

inaccurate Fact

Sheet is

provided for the

Assignment, or

is missing.

The responses

explaining the

policy or

regulation

selected are

vague and

inaccurate, or

are missing.

The responses

explaining the

impact of the

policy or

regulation

selected on

system

implementation

are vague and

inaccurate, or

are missing.

The responses

explaining the

impact of the

policy or

regulation

selected on

clinical care,

patient/provider

interactions,

and workow

Name: NURS_5051_Module06_Week11_Assignment_Rubric EXIT

Grid View List View

8/5/2019 Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16569051_1&rubric_id=_1068954_1 2/3

Excellent Good Fair Poor

interactions, and

workow.

· Highlight

organizational

policies and

procedures that

are/will be in

place at your

healthcare

organization to

address the

policy or

regulation you

selected. Be

specic.

and workow.

Specic and

accurate

responses

thoroughly

highlight in

detail the

organizational

policies and

procedures that

are/will be in

place at a

healthcare

organization to

address the

policy or

regulation

selected.

Includes: 3 or

more peerreviewed

sources and 2

or more course

resources.

are/will be in

place at a

healthcare

organization to

address the

policy or

regulation

selected.

Includes: 2 peerreviewed

sources and 2

course

resources.

The responses

highlighting the

organizational

policies and

procedures that

are/will be in

place at a

healthcare

organization to

address the

policy or

regulation

selected are

vague or

inaccurate.

Includes: 1

peer-reviewed

source and 1

course

resource.

are vague and

inaccurate, or

are missing.

The responses

highlighting the

organizational

policies and

procedures that

are/will be in

place at a

healthcare

organization to

address the

policy or

regulation

selected are

vague and

inaccurate, or

are missing.

Includes: 1 or

fewer

resources.

Written

Expression and

Formatting –

Paragraph

Development

and

Organization:

Paragraphs

make clear

points that

support well

developed ideas,

ow logically,

and demonstrate

continuity of

ideas. Sentences

are carefully

focused–neither

long and

rambling nor

short and lacking

substance.

5 (5%) – 5 (5%)

Paragraphs and

sentences

follow writing

standards for

ow, continuity,

and clarity.

4 (4%) – 4 (4%)

Paragraphs and

sentences

follow writing

standards for

ow, continuity,

and clarity 80%

of the time.

3.5 (3.5%) – 3.5

(3.5%)

Paragraphs and

sentences

follow writing

standards for

ow, continuity,

and clarity 60%-

79% of the time.

0 (0%) – 3 (3%)

Paragraphs and

sentences

follow writing

standards for

ow, continuity,

and clarity < 60% of the time. 8/5/2019 Rubric Detail – Blackboard Learn https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16569051_1&rubric_id=_1068954_1 3/3 Excellent Good Fair Poor Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/intext citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) APA format errors. 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_5051_Module06_Week11_Assignment_Rubric Policy/Regulation Fact Sheet Assignment

NRS-434V Week 5 Movie Character Health Assessment Presentation

In this assignment, you will be creating a PowerPoint presentation based on the application of the functional health assessment of a movie character. To complete this assignment, choose a movie from the following list and identify a character from the movie on whom you would like to do a health assessment. If you wish to use a character from a movie not included on the following list, get the approval of your instructor.

Away From

HerLorenzo’s Oil

Mask

My Sister’s Keeper

Philadelphia

Rain Man

Steel Magnolias

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Stepmom

The Elephant Man

The Mighty

The Tic Code

 

1.Create a PowerPoint presentation of 10-12 slides using the template “Movie Character Presentation.”

2.Provide an introduction and background overview of the movie character (client). NRS-434V Week 5 Movie Character Health Assessment Presentation.

3.Assess the client using the “Functional Health Pattern Assessment.”

4.Based on your “observations” and thoughts, document your assessment, providing examples from the movie.

5.Describe any observed or potential cultural, geographic, religious, ethnic, or spiritual considerations of this client.

6.Describe two normal health patterns of the client as well as two abnormal health patterns that you observe, and provide examples.

7.Develop an appropriate nursing diagnosis for the client based on your assessment.

8.Identify and describe three interventions for the client: health promotion, health prevention, and maintenance.

9.Identify at least two possible resources or community services to which you would refer this client and provide rationale for your choices.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment. NRS-434V Week 5 Movie Character Health Assessment Presentation.

 

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

 

Post your assignment to the Movie Character Health Assessment Presentation Main Forum as directed by instructor. Respond to other learners’ posts in a manner that initiates or contributes to discussion. Each person should make at least three substantive comments.

 

Submit your assignment to the drop box addition to posting it to the Movie Character Health Assessment Presentation Main Forum. NRS-434V Week 5 Movie Character Health Assessment Presentation

Ethics in pediatric and adolescent nursing essay

Ethical Dilemma: A Pediatric Patient

Adolescents experience many changes in transitioning into adulthood; it is the most plausible period in life to be referred as the time of “storm and stress” (Hockenberry & Wilson, 2014).  Self-image is a component in their development that can be easily altered through the thoughts of their peers, the labels in media, family views, etc., which can mislead their perception of health and individual growth.  An unfortunate and common impedance towards a healthy development in adolescence is eating disorders; anorexia nervosa being one of the most prevalent of all, can lead to considerable morbidity and mortality if left untreated (Smink, Hoeken, & Hoek, 2012). Ethics in pediatric and adolescent nursing essay Nurse’s face being placed in a difficult position when providing holistic care to the patient with anorexia nervosa becomes an ethical dilemma due to the conflicting beliefs between patients, their parent’s beliefs and the nurses/healthcare team.

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Ethical considerations in treating a hospitalized adolescent patient which the nurses face are conflicting values in their duty to providing an optimum level of care to promote an optimum level of health for the patient.  It is more difficult when the decisions for treatment go against that of the minor; and therefore, receiving treatment against the minor patient’s will; This then causing tension between the patient and nurse/healthcare provider in achieving a trusting-working relationship.

The American Nurses Association (ANA)has provided nurses with a scope of ethical standards, called the “Code of Ethics for Nurses” with detailed descriptions of the nine provisions, which aid in providing guidance to nurses in providing roles and obligations of nurses when delivering patient care and maintaining an ethical/moral healthcare environment between all healthcare providers (ANA, 2015). Ethics in pediatric and adolescent nursing essay Provision one states, “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person” (ANA, 2015).  Although it is the nurse’s role to respect the rights of the patient without the need for the nurse to agree with decisions made.  The patient has “the moral and legal right to determine what will be done with and to their own person” (ANA, 2015) but when the decision of the patient are self-destructive, like the choice of anorexia; it is the nurse’s obligation to address the behavior and provide modifying behavior resources and help to eradicate the potential for any risks for the patient.  It is important to promote the patient’s autonomy; therefore, educating the patient and providing them with resources and opportunities to help him/her with making health-promoting decisions is an important aspect in caring for a patient dealing with anorexia.

Another provision made by the ANA that will aid the nurse in caring for the patient with anorexia is Provision four; “The nurse has the authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care”(ANA, 2015). Part of a nurse’s role is to create a trusting nurse-patient relationship, but with a patient that will refuse treatment as a pediatric patient hospitalized for treatment against his/her will this trusting relationship will most likely will be compromised.  Provision four understands this possible conflict and endorses nurses to assume authority and responsibility to accept or reject specific role demands in order to provide optimal nursing care. Ethics in pediatric and adolescent nursing essay.

All in all, the desired outcome of this ethical dilemma is to eliminate any health disparities to the patient by educating, caring, and promoting a healthy life to the pediatric patient.  Although some ethical dilemmas take time till they are resolved due to non-agreement to medical treatment and enablement of patient self-determination some resources that could help alleviate and hopefully eventually solve in the case of a pediatric patient hospitalized for treatment of anorexia are, family, providing physician, nutritionist, social worker, psychiatrist, and other healthcare staff; it is possible to provide holistic care for the patient and help alleviate or eliminate any conflict in treatment by following the standards of nursing and using the ANA Code of Ethics to aid in providing care Ethics in pediatric and adolescent nursing essay.

References

American Nurses Association. (2015).
Code of ethics for nurses with interpretive statements
. Retrieved from: http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html

Hockenberry, M. & Wilson, D. (2014) Wong’s nursing care of infants and children (10th ed.). St. Louis, MO: Elsevier.

Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: incidence, prevalence and mortality rates.
Current Psychiatry Reports
,
14
(4), 406–414. http://doi.org/10.1007/s11920-012-0282-y

Required Uniform Assignment: Ethical Dilemma

P
URPOSE

For this assignment, you will examine ethical dilemmas that exist in pediatric acute care settings, particularly
those involving genetics/genomics issues. You will also explore the resources available to assist patients,
families, and healthcare professionals in solving these dilemmas, and integrate the principle of the ANA code of
Ethics. Ethics in pediatric and adolescent nursing essay.

C
OURSE
O
UTCOMES

This assignment enables the student to meet the following course outcomes.

CO #1: Provides individualized comprehensive care for children and their families with multiple health problems in
institutions and community care settings from birth through adolescence. (PO #1)

CO #4: Utilizes critical thinking skills in clinical decision making in the care of pediatric clients. (PO #4) Ethics in pediatric and adolescent nursing essay.

CO #6: utilizes legal, ethical, and professional standards and principles, including those related to child abuse recognition
and intervention, as a basis for pediatric clinical decision
‐
making. (PO #6)

D
UE
D
ATE

Refer to Course Calendar for details. The Late Assignment Policy applies to this assignment.

T
OTAL
P
OINTS
P
OSSIBLE

100 points

R
EQUIREMENTS


Write a 2
‐
3 page paper (not including the title page and reference page) using APA format.


Describe an ethical dilemma you encountered in your clinical setting. Example topics related to
genetics/genomics issues include, but are not limited to: genetic testing, diagnosis of a genetic disorder,
genetic counseling (or lack thereof), pharmacogenomics, lifelong surveillance, and recruiting individuals
for genetics research. Keep in mind to maintain the privacy of all members involved in the dilemma.

P
REPARING THE
A
SSIGNMENT


Identify all the relevant and applicable principles within the ANA Code of Ethics that relates to your
dilemma.


Describe in detail how your dilemma relates to the principle(s) you have identified.


Discuss the outcome of the dilemma to the best of your knowledge Ethics in pediatric and adolescent nursing essay.


Discuss the resources within the clinical agency for dealing with such ethical dilemmas.


Utilize resources such as your textbook, journal articles, Internet sites, etc, to aid in your discussion and
to support your perspective about the situations.


Complete the assignment using APA formatting. Include a reference page in APA format of sources
used. You must use at least two references in this assignment (one will be the ANA Code of Ethics).

N328 RUA Ethical Dilemma for JUL16.docx
Revised 06/2016
2
N328 Pediatric Nursing
D
IRECTIONS AND
A
SSIGNMENT
C
RITERIA
Assignment
Criteria
Points
%
Description
Dilemma
Description
(15 points)
15
15%
Describe the ethical dilemma, including how you became aware of the
situation and who was involved (family, health, care providers, etc…)
Identify the
Principle(s) from
the ANA Code of
Ethics
(10 points)
10
10%
Include all the ethical principles that are relevant and applicable to the
situation. Include a brief description of each principle identified.
Relate Principles
from ANA Code
of Ethics to the
Dilemma
(30 points)
30
30%
Describe how the ANA Code of Ethics principles relate to the dilemma.
Provide specific examples from the situation to demonstrate this
relationship.
Utilize resources such as your textbook, journal articles, professional
internet sites, etc. to aid in your discussion and to support your
perspective about the situations.
Must have at least 2 references, one being the ANA Code of Ethics and one
journal article from a primary source.
Discuss the
Outcome of the
Dilemma
(15 points)
15
15%
How did the situation develop over the time frame you were caring for the
patient? What outcome was hoped for, if no resolution occurred during
that time frame?
Identify the
Resources at the
Clinical Agency
to Assist Dealing
with Ethical
Dilemmas
(20 points)
20
20%
What resources are available? Which were being used and for what
reason(s)? In your opinion, were any other resources available, but not
being used and should have been used in this situation? Provide
rationales for your opinions. Support with literature (highly
recommended).
Writing Style,
APA format,
grammar,
spelling, and
mechanics
(10 points)
10
10%
Proper APA format, grammar, mechanics, and spelling.
Total
100
100

The main aim of the Pediatric Acute Care Unit is to prepare graduate nurses for specific opportunities in the care of unstable intensely ill children.  These graduates are prepared to provide services in hospital inpatient and outpatient situations such as the Emergency Room and pediatric intensive care, and mastering the crucial care of an extensive variety of clinical problems realized from infancy through young adulthood (Jaynes & Lundy, 2014)

There are ethical dilemmas in this setting ranging from genetics and genomics issues. I came to make this conclusion after visiting one such unit and found a nurse who was having these challenges with his patients and their families (Ladd, Smith, & Pasquerella, 2008)

Privacy and Confidentiality, the nurse was required to observe confidentiality with his adolescent patient and surviving with a revelation of diagnosis to him. His parents were also not adhering to his treatment. There were unpredicted responses from family members after he directed who should have access and control to his genetic information (Garvin & Meares, 2000)

Discrimination .This nurse had been required by the employer to take genetic examinations as a condition of hire. He was concerned about his results being misused, like in employment discrimination and also the genetic information being used to deny insurance coverage or to determine who is hiring or firing (Garvin & Meares, 2000) Ethics in pediatric and adolescent nursing essay

Unequitable access to Genomic equipment, this care had limited equipment, making genomic treatments challenging to offer. He mainly relied on governmental organizations that assisted him in endorsing genetic and genomic treatment by creating numerous tools and assets that address the role of genetics in public health. (Ladd, Smith, & Pasquerella, 2008)

Aiding treatments for genetic ailments affecting a small number of people was also a challenge. He realized that not many people were ready to fund for the treatment in marginalized groups such as the street children since the question about the beneficiary of such treatment was paramount among the potential funders. (Jaynes & Lundy, 2014)

Influence of genetic information. How did the person’s genetic information affect individual and society’s insight of that individual, how did this information affect members of minority communities. He was tasked with explaining to his patients the need for well-versed decision making and making them understand the nature, risks, and benefits of the procedure. (Garvin & Meares, 2000) Ethics in pediatric and adolescent nursing essay

Logical property matters surrounding access to and use of genetic Information. The nurse was involved in finding the patient kinfolk histories. There were situations where it is necessary to collect medical information from the patient’s family members, forcing him to explain the procedure to them and support their written agreement for the release of their medical information (Ladd, Smith, & Pasquerella, 2008)

Decent, lawful and social aspects that influence the conversion of genetic information to improved health (Jaynes & Lundy, 2014)

Issues of conducting genetic research.GWAS studies advocate for the use of traditional accord, binary, and tiered accord. Traditional consent had some participants who only participated and didn’t agree to share their data. This restricted the number of individuals willing to participate in it. A binary accord also saw participants who chose not to share their data (Ladd, Smith, & Pasquerella, 2008) Ethics in pediatric and adolescent nursing essay

Using the genetic information in non-health care situations; Genetic testing on DNA can be done on stored blood that has been collected for other works. Data sets of DNA are being established. The nurse found himself his workmates using their patient’s DNA sample for extra research and testing without the patients’ knowledgeable consent (Garvin & Meares, 2000)

The impact of genomics on the race ethnicity and individual identity are; Baby screening results were linked to psychological jeopardies among parents such as parental guilt in parents who were carriers. Infants recognized as carriers led to misunderstanding between parents, interfering with parent-child relationship resulting in social discrimination (Fowler, 2008)

ANA code of ethics

Respect for humankind. In the provision of care, the nurse ought to abide by the beliefs of the individual. The nurse considers the values of all persons in the professional relationship (Fowler, 2008)

Relationships to patients; Health care is worldwide regardless of patient’s variances. The nurse creates helpful links with patients and respect for the morals and beliefs of the patient should not demand the nurse condone those beliefs on an individual level. (Association, 2011)

Nature of health complications; the nurse should not allow the illness of the patient to control his/her worth. This encompasses the relatives of the patient and the health field. The nurse should offer unbiased information and provide security to the patient even when those measures accelerate death. This prevents suffering in the dying process. The nurse does not act with the individual intent of ending a patient’s life (ANA code of ethics)

Right to self-determination; Patients have the right to choose what is to be done to them and part of this includes the right to information needed to make progressive decision on health care (ANA code of ethics) Ethics in pediatric and adolescent nursing essay

Relationships with colleagues; the nurse upholds caring relationships and is compassionate with commitment to fair handling of others (ANA code of ethics)

Interests of the patient are prime; the vital interest of the nurse is to provide unique care based on the necessities of the patient. The nurse guarantees the patient that he finds the plan of care acceptable (Association, 2011)

Conflict of interest for nurses. Nurses may encounter circumstances with conflicts of interest. The nurse shouldn’t exploit the patient for personal gain. This principle can prevent using Genetic Information in Non-Health Care Settings since it advocates for the nurse to others what he would like done towards him (Association, 2011)

Privacy. The nurse acts as an advocate for the patient’s right to privacy. He safeguard’s the patient’s privacy and sensitive information. This can be used to solve privacy and confidentiality. Dilemma (ANA code of ethics)

Guarding the patients in research; The patient has the right to make a well-versed conclusion on their partaking is an investigation, nurses have an accountability to ensure patients are offered with information on any research performed. This principle relates closely to the challenge of information confidentiality (Fowler, 2008) Ethics in pediatric and adolescent nursing essay

Moral self-respect. Nurses have the moral obligation to self as they do to others. They must uphold self-respect, character, and integrity. This can be used to solve the issue on using Genetic Information in Non-Health Care Settings (Association, 2011)

Dilemma outcomes

Difficult interactions with patients and their families on issues like ensuring confidentiality, especially in adolescent care are common.

Challenges in incurable circumstances like accepting the decision of coworkers of admitting the patient in ICU

Health professionals are disagreeing with the breach of confidentiality or inappropriate use of medicines.

Coping with violence against children and neglect where no one was willing to fund them.

The following resources were available at the clinical agency I happened to visit:

Journal of pediatric health care

Journal of pediatric nursing

Pediatric nursing journal

Ethics in pediatric and adolescent nursing essay

A copy of ANA code of ethics.

However, I noticed that these resources were not well utilized and only the ANA code of ethics was being used widely due to its availability. The other resources were scarce and couldn’t be utilized as required.

 

References

Association, A. N. (2011).
Code of Ethics for Nurses with Interpretive Statements.
Retrieved from https://books.google.com/books?isbn=1558101764

Fowler, M. D. (2008).
Guide to the Code of Ethics for Nurses.
Retrieved from https://books.google.com/books?isbn=1558102582

Garvin, C., & Meares, P. A. (2000).
The Handbook of Social Work Direct Practice.
Retrieved from https://books.google.com/books?isbn=0761914994

Jaynes, S., & Lundy, K. S. (2014).
Community Health Nursing.
Retrieved from https://books.google.com/books?isbn=1449691498

Ladd, R. E., Smith, S., & Pasquerella, L. (2008).
Ethical Issues in Home Health Care.
Retrieved from https://books.google.com/books?isbn=0398085978 Ethics in pediatric and adolescent nursing essay