Case Study Ethical Legal Dilemma Advanced Practice Nursing

Demonstrate integrity through the application of relevant codes of conduct and social responsibility within one’s profession.

Please take a moment to watch this Assignment Introduction, or read the presentation transcript.

Instructions:

• Create an ethical legal decision-making dilemma involving an advanced practice nurse in the field of education, informatics, administration, or a nurse practitioner. Apply relevant codes of conduct that apply to the practice of nursing and your chosen field.
• Include one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts.
• Construct a decision that demonstrates integrity and that would prevent violation of the ethical principle and prevent the law from being violated.
• Describe the legal principles and laws that apply to the ethical dilemma.
• Support the legal issues with prior legal cases or state or federal statutes.
• Analyze the differences between ethical and legal reasoning and apply an ethical-legal reasoning model in the case study to create a basis for a solution to the ethical-legal dilemma.
• List three recommendations that will resolve advanced practice nurses’ moral distress in the dilemma you have presented.
• Based on the issue you presented and the rules of the law, apply the laws to your case and come up with a conclusion.

Note:

• This is a fact-based Assignment that will not include your opinion.
• This will require research and support for what is written.
• The Assignment should be in your words after reading the scholarly and fact-based publications and have proper citations. There should be no quotations. The professor wants to hear your voice as a masters trained nurse.

Description

In the Unit 2 topic 1 Discussion, you chose an ethical-legal dilemma that would cause the advanced practice nurse moral distress. You will write the introductory paragraphs for the Unit 4 Assignment.

You will continue working on the topic you have chosen and submit the paper using the most recent version of APA format. The paper should have a minimum of seven citations and some of these should be case law or applicable statutes. The Library has Westlaw Campus Research database where you can find case laws that relate to your topic. The APA Manual and the textbook have instructions on legal formatting.

4 pages not including tittle page or references.

Ethical Dilemma Discussed in Unit 2

As an advanced practice nurse in a clinical setting, there will be many instances in which contact with ethical-legal dilemmas will occur potentially causing a great deal of stress on personal morals (Pattison, 20015). As a practicing RN in the ICU, I have faced many obstacles pertaining to ethical-legal dilemmas. For instance, a 43 year old patient presented to the ICU with a case of T-cell lymphoma has been treated with multiple rounds of chemotherapy. Unfortunately, these rounds of chemotherapy led to her neutropenic count to drop and subsequently developed septic shock. As a result, her organs went into failure, necessitating total care including intubation. Following neurological assessments, tests, and overall presentation of the case, the prognosis was poor, and physicians agreed to diagnose the patient with cerebral death. In this case, the family was unwavering in their attempts to keep the patient ventilated and alive with total care as they were suffering from the first stage of grieving (Newman, 2014). As a result, this conjured a large degree of frustration to the staff nurses and clinicians working on the case. In this particular case, there are many variables that can be discussed regarding the legal implications of brain death and the process in physicians derive to the conclusion of brain death. Additionally, according to the hospital policy on ethical decision making every patient or the surrogate has the right of refusal of treatment/testing. As a future practicing clinician, this paper serves to embody the role of the advanced practice nurse to discuss the implications of brain death covering the legal aspects regarding the challenge of patient family refusal and what is beneficent for the patient and ethical-moral consideration (Joynt et al., 2015).

References

Joynt, G. M., Lipman, J., Hartog, C., Guidet, B., Paruk, F., Feldman, C., & … Sprung, C. L.

(2015). Communication: The Durban World Congress Ethics Round Table IV: Health care

professional end-of-life decision making. Journal of Critical Care, 30(1), 224-230.

doi:10.1016/j.jcrc.2014.10.011

Newman, L. (2014). Strategies for handling ethical problems in end of life care: obstacles and

possibilities. Nursing Ethics, 22(7), 778-789. doi:10.1177/0969733014547972

Pattison, N., O’Gara, G., & Wigmore, T. (2015). Negotiating transitions: involvement of critical

care outreach teams in end-of-life decision making. American Journal of Critical Care,

24(3), 232-240. doi:10.4037/ajcc2015715

 

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Assignment

Evaluation of Healthcare technology

Directions:

For this assignment, write a 1,000-1,250 word paper in which you:

Select a technology that has been explored in the course. Like Electronic medical record

Perform an assessment using elements of user-technology interface or human factors methods to determine functionality.

Using the content in the readings and textbook, list three elements that will be used to evaluate the user-technology interface.

Select a technology and list the elements that will be evaluated. Include their definition and describe how the element would be measured or evaluated.

For each element, propose practicable suggestions for improvement using support from the literature.

Note

All content must be fully answered in depth. Only utilizing scholarly nursing journals will be accepted with a few online reputable resources (WebMD, health.gov, etc) accepted. assignment requires using a minimum of 3 scholarly nursing journals to support work.

 

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I’m doing a drug card assignment using flashcards for all those 10 words. i need to write in the flashcard about the labeled uses, unlabeled uses, action, normal dose ranges, side effects, lab monitoring, and nursing considerations for each of the words. you must answer all of them.. i need the answers so i can write it in flashcards.

1) Valproic Acid

2) Carbamazepine

3) Meclizine

4) Amphetamine Sulfate

5) Methamphetamine

6) Benztropine Mesylate

7) Amantadine HCL

8) Pyridostigmine

9) Pilocarpine

10) Timolol Maleate

Instructions: For each of the drugs, please answer the following.

labeled uses:

Unlabeled Uses

Action:

Normal Dose ranges:

Side effects:

Lab Monitoring:

Nursing Considerations:

Make sure to write at least a parapgraph for each if you can.

 

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Please respond with a paragraph to the following post, add citations and references:

What nursing intervention are appropriate for Mrs. J at the time of her admission?

* Begin with H&P questions and obtain vital signs

* Administer O2 with low sats

* Assess lung sounds and for areas of congestion

* Obtain EKG

* Order initial lab tests (CBC, BMP, BNP and NT-pro BNP, urinalysis and electrolytes)

* Manage patient anxiety

What is the Rational for administration of medications?

1. IV furosemide (Lasix)

* Increases renal excretion of water, sodium, chloride, magnesium, potassium and calcium*

* Loop diuretic that inhibits absorption of sodium and chloride ions

* Reduces extravascular volume by inducing diuresis and decrease preload and work of heart. Decreases edema, pleural effusion and possibly blood pressure (Drug Guide.com, 2018).

2. Enalapril (Vasotec)

* Angiotensin II is a neurohormone, or chemical messenger, which helps control the cardiovascular system.

* Antihypertensive which causes vasodilation of peripheral vessels decreasing afterload resistance and effective in heart failure.

* ACE inhibitors, like enalapril, block angiotensin I from being converted to angiotensin II, which essentially allows the blood vessels to relax and expand leading to lower blood pressure

* The use of ACE inhibitors will increase potassium levels in the blood and positively offset the use of Lasix (Drug Guide.com,2018)

3. Metoprolol (Lopressor)

* Treats high blood pressure, chest pain (angina), and heart failure.

* Relaxes blood vessels and slowing heart rate, which improves blood flow and lower blood pressure.

* Beta blockers (Metoprolol) blocks these beta-1 receptors from allowing the attachment of hormones so that the autonomic response system does not illicit responses of increased heart rate, pumping force and blood pressure.

* Blocks the beta cells and controls heart rate, decreased pumping action, and decreased blood pressure.

4. IV Morphine Sulphate (Opioid)

* Reduces anxiety and decreases work load of breathing

* Decreased sympathetic nervous system response

* Morphine can cause relaxation of arterial and venous dilation

* Decreased filling pressures

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Coronary artery disease and heart attack. Coronary artery disease is the most common form of heart disease and the most common cause of heart failure. The disease results from the buildup of fatty deposits (plaque) in your arteries, which reduce blood flow and can lead to heart attack.

High blood pressure (hypertension). If your blood pressure is high, your heart must work harder than it should to circulate blood throughout your body. Over time, this extra exertion can make your heart muscle too stiff or too weak to effectively pump blood.

Faulty heart valves. The valves of your heart keep blood flowing in the proper direction through the heart. A damaged valve due to a heart defect, coronary artery disease or heart infection forces your heart to work harder, which can weaken it over time.

Diabetes. High blood sugar can damage inside walls of heart muscle. A fatty substance called plaque can begin to collect in arteries and slows down blood flow. This means the heart must work harder to get oxygen and blood flow to areas of the body. Also increases risk of arteriosclerosis (Web MD, 2017).

Nursing interventions to prevent development of heart failure in each condition

Initiate lifestyle changes to reduce CAD such as diet, exercise, reduce stress levels and quit smoking.

Interventions to manage hypertension are lose extra weight, monitor blood pressure, exercise at least 30 minutes daily, eat a healthy diet and reduce sodium.

Interventions to manage Diabetes are managing weight, physical activity, control blood glucose levels, healthy eating and know your A1C scores (Web MD, 2017).

Measures to help prevent endocarditis include having regular dental checkups and performing good oral hygiene such as flossing and brushing (mayoclinic.org, 2017).

Four nursing interventions that can help prevent these problems:

1. Review list of prescribed medications with patient and family. Educate patient on why medication has been ordered and discuss dosage and frequency. Keep log of time and frequency of medication and contact information for refill.

2. Teach patient about side effects of medication and what to do if they experience severe problems. Discuss any dietary restrictions with medications.

3. Patients should bring a list of their medications to each medical appointment. This helps physicians and patients stay on the same page about which medications the patient is taking and eliminate confusion regarding discontinued ones.

4. Remind patients to make notes regarding any side effects when starting a new medication and to notify physician with any problems. Physicians can determine if the side effects are normal or if a new medication should be ordered.

Reference

Drug Guide.com, (2018). Furosemide, Enalapril, Metoprolol, Morphine Sulphate. Retrieved from https://www.drugguide.com/ddo/view/Davis-Drug-Guid… March 10, 2019

Mayo clinic (2017). Heart Failure symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142March 11, 2019

Web MD, (2017). What does Diabetes do to your heart disease? Retrieved from https://www.webmd.com/diabetes/guide/diabetes-link… March 11, 2019

 

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