1. Describe the values that you honor as a family? 2. Does your family have a history of health complications?

Family Health Assessment
Order Description
Details:
Select a family to complete a family health assessment. (The family cannot be your own.)

Before interviewing the family, develop three open-ended, family-focused questions for each of the following health patterns:

Values, Health Perception
Nutrition
Sleep/Rest
Elimination
Activity/Exercise
Cognitive
Sensory-Perception
Self-Perception
Role Relationship
Sexuality
Coping
NOTE: Your list of questions must be submitted with your assignment as an attachment.

After interviewing the family, compile the data and analyze the responses.

In 1,000-1,250 words, summarize the findings for each functional health pattern for the family you have selected.

Identify two or more wellness nursing diagnoses based on your family assessment. Wellness and family nursing diagnoses are different than standard nursing diagnoses. A list of wellness and family nursing diagnoses, from J. R. Weber’s Nurses Handbook of Health Assessment (5th ed.), can be found at the following link

http://web.archive.org…

Prepare this assignment according to the guidelines found in the APA Style Guide,

Interview Questions for family health assessment
Values, health perceptions
1. Describe the values that you honor as a family?
2. Does your family have a history of health complications?
3. What health issues the family members have? Have there been any actions taken? If yes, were they successful or not?
Nutrition
1. Do you eat healthy meals?
2. Do you prefer cooking your own meals or eating outside?
3. Did you face any problems in accessing healthy nutrition?
Sleep/rest
1. How many hours do you usually sleep?
2. What time do you go to bed and wake up?
3. How cozy is your sleeping area?
Activity/exercise
1. How often do you exercise?
2. What kind of exercises do you prefer?
3. Do you exercise at home or you have a membership in fitness club?
Cognitive
1. How will you rate your IQ?
2. Do you take IQ tests?
3. Do you participate in cognitive activities, and how often?

Sensory-perception
1. Would you consider all your senses fully functioning?
2. How do you tell?
3. Do you have any problems in any of your senses?
Self-perception
1. What are your most important values?
2. Would you describe yourself as an optimist or pessimist?
3. Where do you see yourself in five years?
Role relationship
1. How many friends do you have?
2. How often do you meet with your friends?
3. Is there anything special that helps you to maintain relationship?
Sexuality
1. How many children do you have and what is their gender?
2. Do your children relate well to their friends of opposite sexes?
3. How often do you discuss sexuality with children?
Coping
1. Have your family faced any serious problems?
2. How did you tell about that to the rest of the family members?
3. Was the problem solved, and how did you cope with that?

 

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1. Why was Cindy at risk for a pressure ulcer? What were some of the contributing factors, and why? 2. What are the symptoms of an egg allergy? Why do you think her allergy was not ever life threatening when she was receiving the nightly tube feedings at home?

Planning Nutrition Therapy for a Complex Pediatric Patient

Order Description
Unit outcomes addressed in this Assignment:
• List the major factors that influence the recovery of a sick child.
• Explain three methods of improving nutrient intake in a pediatric patient with a chronic disease.
Course outcomes addressed in this Assignment:
NS335-5: Design a realistic and therapeutic meal plan for a patient with a severe food allergy or disease that prohibits certain types of foods or nutrients.
GEL-8.3: Formulate a logical solution to a problem.
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
Unit 8 Assignment
Unit outcomes addressed in this Assignment:
• List the major factors that influence the recovery of a sick child.
• Explain three methods of improving nutrient intake in a pediatric patient with a chronic disease.
Course outcomes addressed in this Assignment:
NS335-5: Design a realistic and therapeutic meal plan for a patient with a severe food allergy or disease that prohibits certain types of foods or nutrients.
GEL-8.3: Formulate a logical solution to a problem.
Instructions:
Imagine that you are a nutrition assistant working at a pediatric rehabilitation center. This rehabilitation center provides care for pediatric patients who are recovering from recent hospitalizations. This facility is considered to be the bridge between hospitalization and home care.
The supervising dietitian has informed you that a new patient was admitted overnight from the nearby hospital and is recovering from a skin graft surgery due to a severe pressure ulcer (bed sore). Imagine that you are asked to review the patient’s chart notes and provide a nutrition assessment summary along with some ideas about what type of therapeutic diet or nutrition therapy she requires.
Patient information from the hospital medical chart:
Name: Cindy
Age: 6-year-old female
Height: 43 inches
Weight: 38 pounds
Admitting Diagnosis (Dx): Cerebral Palsy, bedridden, stage 3 pressure ulcer on sacrum, food allergy to eggs
Surgery: Skin graft performed to increase healing and reduce further infection risk.
Diet order: Thickened liquids and pureed foods with precautions due to dysphagia (swallowing deficiencies) associated with CP. No eggs: Severe Egg Allergy.
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
Speech/Cognitive: Patient receives speech and swallowing therapy due to CP. Her speech and cognitive abilities were reported to be around that of a 2-year-old.
Cindy normally resides at home with her family. She qualifies for state-funded home medical assistance due to the CP diagnosis. She is bedridden and relies on the home health nursing assistants for care. Her parents have three other children and involve her in as many family activities as possible, but the actual care is provided by the in-home medical team. Cindy has had a gastrostomy feeding tube (G-tube) since she was just a few months old. In recent years, it has only been used nocturnally if her oral intake of the pureed/soft diet foods fell below the 50% mark for two or more meals. She received a specialized enteral formula that did not have eggs as any source of the protein.
For many years, Cindy was cared for by the same team of nurses and nursing assistants, and she did not have any major medical or nutrition-related problems. However, about 6 months ago, the state funded program changed home care contract companies and a new company began to provide care. Cindy’s parents felt that the care was sub-standard and reported it numerous times, but without any improvements. It was not until Cindy’s quarterly check-up that these problems were identified. Her weight had dropped by 15% in just 3 months, her albumin was low, and her lean muscle mass and strength had decreased. Most alarmingly, she had developed a pressure ulcer on the sacrum. The MD immediately admitted Cindy into the hospital.
Upon further investigation, the new home health company had been administering nocturnal tube feedings with a formula that contained egg as one of the partial sources of protein. They thought that it was a comparable substitute for the previous brand. Additionally, they had misread the original nutrition order to only give night enteral feedings (via the G-tube) if her oral intake was insufficient. Until the issues were discovered, Cindy went several months receiving a full night of tube feedings that provided a feeling of fullness to her. She also was suffering from chronic diarrhea and associated malabsorption. Subsequently, she would not feel well enough to eat the next day and the cycle repeated itself daily. She also started having many more nasal and respiratory symptoms, which the new care providers explained away as being typical seasonal allergies. She was prescribed an antihistamine. Her parents were unaware of the nocturnal tube feedings because the nursing staff would run them about 8–10 hours while the patient was asleep.
Questions to address:
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
1. Why was Cindy at risk for a pressure ulcer? What were some of the contributing factors, and why?
2. What are the symptoms of an egg allergy? Why do you think her allergy was not ever life threatening when she was receiving the nightly tube feedings at home?
3. Take into consideration her multiple medical conditions of cerebral palsy, egg allergy, and recent pressure ulcer, and calculate her estimated calorie needs and protein needs.
4. Recommend an appropriate tube feeding formula brand name or type that has no albumin from egg protein (for the days that she does not have adequate oral intake of her meals).
5. Appendix: Design a full-day meal plan for Cindy that includes pureed/soft foods. This diet needs to fully address her CP-related chewing/swallowing challenges. Be sure to consider her protein needs for wound healing promotion and future prevention, but without foods containing eggs or egg by-products. Oral protein drink supplements can be considered. Include the total calories, carbohydrates, fats, protein, and any micronutrients that are important in this case.
Requirements: Please include the answers to questions 1–4 in an essay of at least 2 pages in length. Incorporate at least three references in APA style within the essay. Part 5/Appendix should be formatted as a well-organized 1-day sample meal plan with a detailed description of the food items and accurate serving size. The meal plan is in addition to the 2 pages for questions 1–4.
Submitting your work:
Submit your Assignment to the appropriate Dropbox. For instructions on submitting your work, view the Dropbox Guide located under Academic Tools at the top of your unit page.
Please be sure to download the file “Writing Center Resources” from Doc Sharing to assist you with meeting APA expectations for written Assignments.
To view your graded work, come back to the Dropbox or go to the Gradebook after your instructor has evaluated it. Make sure that you save a copy of your submitted work.
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
Unit 8 Assignment Grading Rubric = 150 points
Assignment Requirements
Points possible
Points earned by student
Student answers each of the following:
Why was Cindy at risk for a pressure ulcer? What were some of the contributing factors, and why?
0–25
What are the symptoms of an egg allergy? Why do you think her allergy was not ever life threatening when she was receiving the nightly tube feedings at home?
0–25
Take into consideration her multiple medical conditions of cerebral palsy, egg allergy, and recent pressure ulcer, and calculate her estimated calorie needs and protein needs.
0–25
Recommend an appropriate tube feeding formula brand name or type that has no albumin from egg protein (for the days that she does not have adequate oral intake of her meals).
0–25
Appendix: Design a full-day meal plan for Cindy that includes pureed/soft foods. This diet needs to fully address her CP-related chewing/swallowing challenges. Be sure to consider her protein needs for wound healing promotion and future prevention, but without foods containing eggs or egg by-products. Oral protein drink supplements can be considered. Include the total calories, carbohydrates, fats, protein, and any vitamins or minerals that are important in this case.
0–40
Required amount of APA style references are used within the paper to effectively support ideas.
0–10
Total (Sum of points earned)
0–150
Kaplan University School of Health Sciences
NS335
Unit 8 Assignment
The Proposal is written in the most current version of APA format with no grammatical, spelling, copyright, plagiarism, or proofreading errors.
Points deducted for spelling, grammar, and/or APA errors.
Adjusted total points earned
Instructor Feedback*:
*Instructor may also leave feedback comments within Assignment submission.

 

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Describe the role of the RN in diabetic education (supported with nursing journal (no online webpage) Prevention What prevention strategies should be taught to the patient to reduce the risk of type II Diabetes? Monitoring What are the key points which should be described to patients in teaching them about self-monitoring of glucose for day to day living, during illness and during activity (support with nursing journal)

Diabetic Paper

Purpose: The diabetic paper will demonstrate the student’s ability to master critical content from the course and apply it to individualized client care, establish the knowledge base to become an effective diabetic client educator as well as demonstrate organization of the student’s critical thinking.
This paper is required in this course, for 40 points. Evaluation of these papers will be based on Rubric below. The paper must show good organization and mechanics (spelling, grammar, etc.). The body of each paper is to be approximately 8-12 pages in length, typed, and following the prescribed guidelines as stated.
Paper Requirements
I. Introduction- opening paragraph should state the topic of the paper, gain the attention of the reader and allow for a smooth transition into the body of the paper.
II. Body of Paper-use two to three word headings for the topic and the grading criteria to formulate headings and guide the body of your paper. Develop paragraphs in a logical, critical way.
III. Closing paragraph-tie it together and make final conclusion.
IV. References: will need three to five references the paper. Three must be Nursing Journals related and one may be your course text. NO INTERNET SOURCE (Mayo, National Diabetes Association) must be nursing journals. The reference page must be in APA format. (Note: published journal articles that are accessed via the online library resources are NOT considered “Internet” sources. Sources with a web address that have not been published in a journal are considered “Internet” sources.)
V. VI.
Paper will be written in APA format: a. one inch margins
b. cover page
c. page numbers at top right-hand corner
d. typed, double spaced
e. Check APA format handbook on the reference page format and citation of references in the text.
f. Exceptions to APA format: no abstract needed for this assignment since there is an introductory
Syllabus
Page 14 of 24
VII.
paragraph required. Please USE headings as outlined in the grading criteria.
Pay close attention to typing, spelling, and grammatical errors. Have a friend check over your paper to
help you correct errors. Tips:
a. This author recommends a nurse can use “I” when writing a professional paper.
b. A nurse ought never to use the word “you” in a professional paper.
c. Spell-check does knot no thee difference when they’re our words with the same sound that are spelled differently: watch out for “not/knot,” their/they’re/there,” “our/are/hour,” etc.
d. Y’all betcha boots ya need to avoid slang or conversational terms. T
e. PLEASE complete the paper early and PLEASE proofread your final copy at least five times! Historically, students tend to lose points most frequently for preventable errors.
Grading: Refer to Grading rubric located below: items to be addressed within this paper include the following topics:
Address all of the items below
Background
Description of both types of Diabetes as explained to patients by nursing staff (so they will understand limit 100 words per type I and type II).
Describe the role of the RN in diabetic education (supported with nursing journal (no online webpage) Prevention
What prevention strategies should be taught to the patient to reduce the risk of type II Diabetes?
Monitoring
What are the key points which should be described to patients in teaching them about self-monitoring of glucose for day to day living, during illness and during activity (support with nursing journal)
Medications
Describe the different insulins include all insulins listed in Table 49-3 of your course text, discuss whether available by pen or vial, how to be stored and administered, onset, peak, duration, and recommended treatment regimen. Finally discuss the problems associated with insulin therapy which include hypoglycemia, allergic reactions, lipodystrophy, and the Somogyi effect and Dawn Phenomenon (when should glucose levels be checked).
Oral agents discuss one drug from each of the following categories Dipeptidyl Peptidase-4 (DPP-4) Inhibitors , Thiazolidinediones, a-Glucosidase Inhibitors, Meglitinides, Sulfonylureas, and Biguanide, discuss its mechanism of action, which type of DM it is commonly used to treat and side effects. Complications
Acute complications, discuss the acute complications of hypoglycemia, DKA, and HHS, what are manifestations, what are the causes, interventions for each.
What are the Macro & Micro Vascular complications that can happen to Diabetics, what are the screening options to prevent these from occurring?
Life styles
What role does diet, activity and exercise play in the management of diabetes?
How does alcohol consumption affect the diabetic patient?
What ways can nurses teach diabetic patients to manage their stress?

Paper must contain 4 nursing journals and 1 scholarly journal.

 

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A. Identify fall risk factors associated in hospital, home healthcare, long-term and hospice facilities. B. Explore safety guidelines established to prevent falls. C. Create or identify a fall risk assessment which will properly alert staff to the patient’s risk for falls. a. Increase education and awareness in fall prevention.

EVALUATION OF PREVENTION AND EDUCATION FOR FALLS IN HOSPITALIZED PATIENTS

Order Description
I would like to use this information in my nursing research paper. It needs to be (APA) 10 pages, not including title and reference pages,
I. Introduction
The main points in my guideline are:
A. Identify fall risk factors associated in hospital, home healthcare, long-term and hospice facilities.
B. Explore safety guidelines established to prevent falls.
C. Create or identify a fall risk assessment which will properly alert staff to the patient’s risk for falls.
a. Increase education and awareness in fall prevention.
My guideline is Fall prevention. In: Evidence-based geriatric nursing protocols for best practice. This guideline was taken from the Hartford Institute for Geriatric Nursing- Academic Institution.
Having a family member fall and as a registered nurse in many diverse settings, I have come to realize the importance of assessing patients for fall risks. There are numerous aspects to consider including age, cognition, and medications. Consequences of falls should not be underestimated. Evidence-based research has improved our need to recognize the need for prevention and education. It is crucial to determine individualized risks for a falls in hospitalized and home healthcare patients.
II. Theoretical Foundation for the Topic
A. The theoretical foundation for the topic is based on Jean Watson?s Caring Theory. The caring moment is the focal point of time in which the nurse cares for another is where human interaction takes place. It consists of the goals and expectations of both the nurse and client or individual being cared for, and the consciousness involved in the caring situation. It requires above all else a conscious presence.
B. Watson emphasized that to be highly involved with caring, a nurse must first become conscious and aware of what is taking place in the immediate moment. Prevention and education of falls in hospitalized patients? encompasses greater wholeness in the community and can resonate from the energy established by such practices.
III. Review of Literature
I used the Jacksonville University Swisher Library database, Ovid, to search for related literature. The search terms I used were fall risks in hospitalized and non-hospitalized patients. The years of the articles were 2006 ? 2012.
Many risk factors can be changed or modified to help prevent falls. Research has identified many conditions that contribute to falling. These are the most common aspects that will be addressed:
A. Older adults who survive a fall experience significant morbidity.
a. Falls are the most common cause of traumatic brain injuries and wrist, arm, ankle, or hip fractures.
B. Certain medications, like blood thinners, can be a serious risk factor.
C. Many people who fall, even if they?re not injured, become afraid of falling.
D. Direct medical costs for fall injuries are costly
IV. Recommendations for Practice
Falls don’t “just happen.” Simple modifications can help reduce the risk of falling. A number of interventions targeted to individuals have been shown to work, but population-based strategies have not been properly evaluated. These points to the need for monitoring and further evaluation including:
A. Administering and providing a determination of risk for falling, based on gender, mental and emotional status, symptoms of dizziness, and known categories of medications increasing risk.
B. Addressing fall hazards, such as volunteering information such as information on their states? fall-prevention screenings, referrals, and programs.
C. Safety rounding, a nurse would check that all precautions to prevent falls were in place, including fall risk armbands, signs, and bed alarms.
D. Having a global electronic health record to alert hospitals, doctor?s offices and home care givers access to the patient?s risks for falls.
V. Conclusion
Fall risk warrants thorough assessment as well as prompt intervention and treatment. There are usually more than one underlying cause or risk factor is involved in a fall. Older adults who have already experienced a fall are at risk for more falls.
A. Fall prevention programs can be cost effective, although more research is required.
B. Electronic health records with targeted interventions that prompt and alert caregivers to modify and/or reduce specific risk factors present.
C. Health and community care organizations need to work together to prioritize fall prevention as part of their overall strategy for promoting a healthy standard of living of advanced years. This helps with post-fall assessments which are essential for evidenced-based approaches to fall risk factor reduction.

 

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Outline the nursing assessment that you would make of Mr Hopper over the next 1-2 days and discuss the significance of these observations, including nursing detection of complications related to an AMI (include subjective and objective data). (approx. 250words)

Mr Hopper develops signs of acute pulmonary oedema (APO). Investigations include arterial blood gases (ABG) which reveal: pH 7.25 PaO2 68 PaCO2 60. He is ordered oxygen and a diuretic (frusemide). Briefly explain the physiological process that occurs in acute pulmonary oedema and list 6 signs or symptoms. In your answer identify the type of acid/base imbalance Mr Hooper has and explain how oxygen and a diuretic will improve his respiratory and cardiac function
Order Description
Question 1: Mr Hopper develops signs of acute pulmonary oedema (APO). Investigations include arterial blood gases (ABG) which reveal: pH 7.25 PaO2 68 PaCO2 60. He is ordered oxygen and a diuretic (frusemide). Briefly explain the physiological process that occurs in acute pulmonary oedema and list 6 signs or symptoms. In your answer identify the type of acid/base imbalance Mr Hooper has and explain how oxygen and a diuretic will improve his respiratory and cardiac function (approx.250 words)
Information related to Acute pulmonary oedema a good source is the Mayo-clinic see link
below
http://www.mayoclinic.org/diseases-conditions/pulmonary-edema/basics/symptoms/con-20022485
? The ABG result of 7.25 is it acidosis or alkalosis this is all you need to outline
? Diuretic removes excess fluid
? Oxygen : why would we give oxygen to someone ?

Question 2: Outline the nursing assessment that you would make of Mr Hopper over the next 1-2 days and discuss the significance of these observations, including nursing detection of complications related to an AMI (include subjective and objective data). (approx. 250words)

Include nursing History (subjective)
The sort of information that you would obtain during an admission process including family
history.
? Nursing assessment ( objective data)
? only need to cover 3 points in total not from each system.
Look at the information from each body system CNS, CVS, Respiratory, GIT, Integumentary,
& musculoskeletal

Question 3: Mr Hopper has recovered well in hospital and discharge planning has commenced. Discuss 5 health services in Tasmania, that could assist Mr Hopper’s recovery. (approx 100words)

 

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Describe the relevance of the nursing research problem addressed in a SRR to practice.

Critique of Systematic Research Review

1. Describe the relevance of the nursing research problem addressed in a SRR to practice.

2. Critique the levels of evidence of the studies used in the SRR, specifically the designs of the studies included.

3. Critique the clarity with which the studies are presented and critiqued.

4. Describe the overall findings of the studies, as summarized in the SRR.

5. Critique the conclusions of the SRR, with implications for your current practice and future research.

6. Utilize the Cochrane Database of Systematic Reviews to locate a true SRR for this assignment.

7. Paper length should be between 4-6 pages.

 

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Describe a clinical topic/situation/issue/ problem that you are curious about. Describe what answer(s) you wanted to know and what you found. Append the abstract from the systematic review to your assignment and a copy of your search.

systematic review

Order Description
The purpose of this assignment is to learn how to locate, understand, and use synthesized evidence to answer research questions to guide nursing practice. conduct a search and choose one systematic review article. In 2-3 pages, double spaced (bullet points are acceptable):
Describe a clinical topic/situation/issue/ problem that you are curious about. Describe what answer(s) you wanted to know and what you found. Append the abstract from the systematic review to your assignment and a copy of your search.
Example/template.
In my practice, I am observing/ hearing ________choose any nursing topic____.
I am curious about __________.
I want to know/ find out who/what/how/why ______.
This is important to know because ___________. (To answer this, ask yourself what would happen if you never knew the answer? How/in what way does the answer support your nursing practice, which could ultimately lead to improvements in the health of the population with whom you are working)?
The key search terms I entered were ______________.
I found ______(enter number) systematic reviews. [If no systematic reviews were found revise your search terms or choose another topic.]
The systematic review (choose one only) I read for this assignment was (enter citation): _____________________.
__________(enter number) individuals studies/articles were included in the systematic review.
The systematic review’s research question/aim/objective/or purpose was ____________.
The key conclusion(s) from the systematic review was/were__________________.
My opinion of this review is _______ because ____________________.
Pls kindly use the template, this is systematic review assignment. choose any nursing topic that interest you or that you will like to know more about and base the systematic review on.

 

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Find a current (2009 or later) primary quantitative research report (report of one study; not a literature review) that is applicable to your specific area of practice and analyze the content of the report, specifically for : Purpose, method, importance, sampling, and data collection of the study.

ANALYSIS OF A QUANTITATIVE RESEARCH STUDY

Analysis of a Quantitative Research Study

Find a current (2009 or later) primary quantitative research report (report of one study; not a literature review) that is applicable to your specific area of practice and analyze the content of the report, specifically for :
Purpose, method, importance, sampling, and data collection of the study.
Data analysis procedures, specific findings, presentation, implications, and effects of the study.
Validity and applicability of the study
The assignment must include: a title page, an abstract, five to six pages of original double space text, and a reference page.
The course texts are to be used to support your analysis.
Use APA 6th edition formatting and correct grammar, spelling, and punctuation.

PLEASE USE THIS FOR REFERENCE IN COURSE TEXTS TO SUPPORT THE ANALYSIS:
Polit, D., & Beck, C. (2012). Nursing research: Generating and assessing
evidence for nursing practice (9th ed.). Lippincott Williams & Wilkins

 

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Identify a case from your experience that contains an ethical issue. What constitutes an ethics case or issue? Students often select cases in which there is a conflict of opinion regarding the best course of action or treatment to pursue. Such conflicts can arise between nurse and patients, among members of the health-care team, between nurses and family members, between patients and family members, and among family members. Conflicts of this type can often be analyzed by focusing on the competing values of each party (e.g., extending life versus minimizing suffering).

Importance of Interperters in Healthcare

Order Description
I had to deal with my cousin passing away from cancer at a very young age of 42. She did not speak English and there were never any translators used when she went to her county hospital appointments. A pap smear was done which indicated she had cancer but was not told this in Spanish but instead “assumed” she understood what was being told to her. No follow up appointment was scheduled, so she assumed everything was well. A year later she became very sick and went back to the county hospital and was told they had informed her of the cancer a year prior and she needed to make an appointment with a oncologist (all of which she did not understand) . She did see an oncologist right after this occurrence but by this time the cancer was spreading and very little could be done for her. She did receive chemo treatment for about 6 months then passed away shortly after. I was very upset because I am a nurse, and if there is ever a need for a translator we get one to make sure the patients fully understand their diagnoses and if any questions they may have they will be answered. I don’t know what happened in my cousins case, but instead of putting her through chemo for her cancer that was not curable I I would have liked her to go back to Mexico and spend whatever time she had left to be with her parents who she had not seen for 10+ years since arriving in the US. She was only able to spend less than a week after arriving to Mexico with her parents because she quickly passed aware. I would like my essay paper to reflect the importance of having Spanish interpreters provided to patients so other patients wont have the same outcomes like my cousin did.
Aurora University
School of Nursing
NUR 4780 Ethics, Culture, Policy in Health Care

Assignment Guidelines: Ethics Case Analysis

Purpose: To demonstrate your ability to recognize interpersonal, communication, spiritual and ethical aspects of medical care and write a well-reasoned description and commentary. In addition the paper provides an opportunity for you to develop your own ability to think about such issues, articulate your own independent thinking and express your reactions and feelings about theses dimensions of care regarding a situation involving one of your own patients.

Case Analysis – The case is to be analyzed following the framework provided below called “Instructions for Preparing Ethics Case Presentations”. The instructions provide six sections that you should complete 1) Narrative of the case, 2) Language and Issues of the Case, 3) Perspectives and Key Points of View, 4) Facilitating Resolution, 5) What Actually Happened, and 6) Commentary. In order to provide this information, the body of the paper is expected to be a minimum of five (5) pages in length and follow APA format. Rarely in this type of paper are references necessary, however, if you consult standard works or use sources to determine or support if your position falls within the range of solutions typically considered ethically acceptable by current practice standards, it is expected you would site your sources.

Instructions for Preparing the Ethics Case Analysis

Select a Case: Identify a case from your experience that contains an ethical issue. What constitutes an ethics case or issue? Students often select cases in which there is a conflict of opinion regarding the best course of action or treatment to pursue. Such conflicts can arise between nurse and patients, among members of the health-care team, between nurses and family members, between patients and family members, and among family members. Conflicts of this type can often be analyzed by focusing on the competing values of each party (e.g., extending life versus minimizing suffering). Presentations of cases involving conflicts can lead to discussions of such ethical issues as autonomy, competence (decision-making capacity), informed consent, paternalism, and the rights and responsibilities of physicians, patients, and family members. Cases can be presented which do not involve any interpersonal conflicts. Students may wish to present a case because they believe that a decision was incompatible with an important ethical norm, value or principle. For example, decision makers who seek to promote a patient’s best interests (as perceived by the physician/nurse and family) may neglect the patient’s right to information regarding the diagnosis, prognosis, and treatment alternatives. Thus, even though a physician and a patient’s family may agree that the patient will not be told that she has cancer, the decision to withhold information may merit ethical examination. Almost any case contains ethical issues because the norms of the doctor/nurse-patient relationship are, ideally, based on ethical principles and motivations. To identify ethical issues, students can select a case and observe how the physician-patient relationship is conducted. Particular attention can be given to how the primary case staff interact with the patient, what and how information is conveyed, how and by whom treatment decisions are made, and how the patient’s decision-making capacity is assessed. If a surrogate decision maker is involved, students might consider the following questions: How and by whom was it decided that the patient lacked decision-making capacity? How was the surrogate selected? Was sufficient information given to the surrogate? Was sufficient consideration given to the patient’s values and best interests in the decision-making process?
What information should I present?
There should be six sections covered in your case presentation:
1. The Narrative of the Case: The student should attempt to present all relevant medical and social facts about the patient. Ethically sound decision-making is based on good medical care and a good factual basis regarding patient care. At all times maintaining confidentiality buy using a fictitious name or initials. (10 points).
2. The Language and Issues of the Case: Cases are often discussed in terms of a particular topic, e.g., informed consent, the decision-making capacity (competence) of the patient, forgoing life-sustaining treatment, physician-assisted suicide, etc. The reasons for choosing one course of action over another are often explained in terms of one of the duties of physicians to patients, respect for autonomy, nonmaleficence, beneficence, or justice. You should not “jargonize” your write up unduly. However, you should be able to identify the topic under which your case falls and to identify the duties to the patient that are involved in the case. (20 points).
3. Perspectives and Key Points of View: This is probably the single most important part of any case analysis. You should go person by person and explain how each saw the situation. Very often, you will find that one or more of the points of view are not well understood by you or others involved in the case. Attempting to understand the reasons and preferences of the parties involved can help to identify important conflicts and their sources. On the other hand, seemingly unresolvable conflicts can be resolved when a sincere effort is made to understand the underlying reasons and values. (30 points).
4. Facilitating Resolution: What approaches might have been taken to bring about case resolution? e.g., family and caregiver conference? Ethics case consultation? A discussion among certain members of the health-care team? Is there any way you could have contributed to the solution? (10 points).
5. What actually happened? Please be sure to include the outcome of the case. (10 points).
6. Commentary: Your commentary should highlight the professional duties that physicians have to patients and how these duties were respected or compromised in the case resolution. (20 points).
It is common for the question of “third person writing” when trying to stay in APA format – to answer the question before it arises. Third person should go without saying for all aspects of the paper, however, when one gets to the commentary it might be more difficult, try. A great deal of weight will not be place on this aspect. But it is expected.

 

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