wk 11 NURS 6512: Advanced Health Assessment and Diagnostic Reasoning
Week 11: The Ethics Behind Assessment
Consider the following scenarios:
You are a nurse at a large county hospital. One of your patients is leaning toward selecting a certain radical treatment for cancer, to which the family is in opposition. The family is concerned about making the correct decision and asks for your advice.
The state of Oregon has passed a “Death with Dignity” act that allows for euthanasia in certain situations. One of your patients suffering from terminal cancer is thinking of moving there to take advantage of this law and asks your opinion.
Throughout this course, you have explored a wide range of health assessments and abnormal examination findings. Although you have predominantly focused on the procedural aspects of health assessment, this week, you will focus on ethical considerations that should be taken into account when advising patients or their families.
This week, you will consider how evidence-based practice guidelines and ethical considerations factor into health assessments. You will also evaluate health assessment concepts related to sports physicals and well-child and well-woman examinations.
Learning Objectives
Students will:
Apply evidence-based practice guidelines to make an informed healthcare decision
Apply ethical considerations to a health assessment response
Apply concepts, theories, and principles relating to sports physicals and well-child and well-woman examinations
Identify concepts, theories, and principles related to advanced health assessment
Learning Resources
Required Readings (click to expand/reduce)
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 24, “Sports Participation Evaluation”
In this chapter, the authors describe the process of a sports participation evaluation. The chapter also states the most common conditions encountered in a sports participation evaluation.
Chapter 25, “Putting It All Together”
In this chapter, the authors tie together the concepts introduced in previous chapters. In particular, the chapter has a strong emphasis on the patient-caregiver relationship.
Tingle, J. & Cribb, A. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Nursing law and ethics (4th ed.). Chichester, UK: Wiley Blackwell.
Furman , C. D., Earnshaw, L. A., Farrer, L. A. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). A case of inappropriate apolipoprotein E testing in Alzheimer’s disease due to lack of an informed consent discussion. American Journal of Alzheimer’s Disease & Other Dementias, 29(7), 590–595. doi:10.1177/1533317514525829.
Navarro-Illana, P., Aznar, J., & Díez-Domingo, J. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Ethical considerations of universal vaccination against human papilloma virus. BMC Medical Ethics, 15(29). doi:10.1186/1472-6939-15-29. Retrieved from http://www.biomedcentral.com/1472-6939/15/29
Maron , B. J., Friedman, R. A., & Caplan, A. (2015 – Research Paper Writing Help Service). Ethics of preparticipation cardiovascular screening for athletes. Nature Reviews Cardiology, 12(6), 375–378. doi:10.1038/nrcardio.2015 – Research Paper Writing Help Service.21
May, K. H., Marshall, D. L., Burns, T. G., Popoli, D. M. & Polikandriotis, J. A. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Pediatric sports specific return to play guidelines following concussion. The International Journal of Sports Physical Therapy, 9(2), 242–255. PMCID: PMC4004129. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004129/
American Academy of Pediatrics. (2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers). Recommendations for preventative pediatric health care (periodicity schedule). Retrieved from https://www.harmonyhpi.com/WCAssets/illinois/assets/IL_MedicaidProviderManual_PEM_AdultPHGsForProviders.pdf
This resource provides recommendations for preventative pediatric healthcare from infancy through adolescence. The periodicity schedule covers a variety of areas, from health history to measurements, developmental/behavioral screenings, physical exams, procedural screenings, and oral health.
Rourke, L., Leduc, D., & Rourke, J. (2017). Rourke Baby Record. Retrieved from http://rourkebabyrecord.ca/
This website provides information on the Rourke Baby Record (RBR). The RBR supplies guidelines on growth and nutrition, developmental surveillance, physical exam parameters, and immunizations for well-baby and child care.
Document: Final Exam Review (Word document)
Assignment: Lab Assignment: Ethical Concerns
Photo Credit: Getty Images/Maskot
As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?
In this Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.
To Prepare
Review the scenarios provided by your instructor for this week’s Assignment. I need help writing my essay – research paper see the “Course Announcements” section of the classroom for your scenarios.
Based on the scenarios provided:
Select one scenario, and reflect on the material presented throughout this course.
What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.
The Lab Assignment
Ace my homework – Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.
By Day 6 of Week 11
Submit your Assignment.
Week 11 Case Study
Posted on: Monday, February 3, 2020 7:57:16 PM EST
Case Study #1: Last names A-H
CASE STUDY 1 The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines.
Case Study #2: Last names I-Q
CASE STUDY 2 A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance.
Case Study #3: Last names R-Z
CASE STUDY 3 A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment
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Week 11: Assessment Ethics
Consider the following:
You work at a big county hospital. One of your patients is considering a radical cancer treatment that his family opposes. You’ve been asked to help the family make the right choice.
Diet with Dignity Act in Oregon allows for euthanasia in specific instances. One of your terminal cancer patients wants to know your thoughts about migrating there to take advantage of the law.
You’ve studied a variety of health assessments and aberrant examination findings. Having previously focused on the technical components of health assessment, this week you will turn your attention to the ethical issues that arise when counselling patients or their families.
These standards and ethical considerations will be discussed this week. Athletes’ physicals and well-child/woman exams will also be evaluated.
Learning Goals
They will:
Make informed healthcare decisions using evidence-based guidelines.
Applying ethical principles to health assessment
Utilize knowledge of sports physicals, well kid and well woman exams.
Identify advanced health assessment concepts, theories, and principles.
Educators
Readings (click to expand/reduce)
Ball, J. W., et al (2019: 2024 – Online Assignment Homework Writing Help Service By Expert Research Writers). A multidisciplinary approach to physical assessment (9th ed.). Elsevier Mosby, MO.
“Sports Participation Evaluation”
The authors outline the evaluation procedure in this chapter. The chapter also lists the most prevalent sports participation evaluation issues.
Chapter 25, “Combining It All”
The authors wrap up previous chapters’ ideas in this chapter. The chapter focuses on the patient-caregiver connection.
Tingle & Cribb (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Ethical nursing law (4th ed.). Wiley Blackwell, Chichester.
Furman, C. D., et al (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Apolipoprotein E testing in Alzheimer’s disease without informed consent. AJAD, 29(7), 590–595. doi:10.1177/1533317514525829.
Navarro-Illana, P., J. Aznar, and J. (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Universal HPV vaccination: ethical issues. 15 BMC Med Eth (29). doi:10.1186/1472-6939-15-29. 1472-6939/15/29 http://www.biomedcentral.com
Maron, B. J., et al (2015 – Research Paper Writing Help Service). Heart screening for athletes: ethical considerations. 12(6), 375–378. doi:10.1038/nrcardio.2015 – Research Paper Writing Help Service.21
May, K. H., et al (2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). Pediatric concussion return to play guidelines 9(2), 242–255. PMC4004129 The National Library of Medicine (NCBI) has this article:
AAP (2008 – Affordable Custom Essay Writing Service | Write My Essay from Pro Writers). Recommendations for pediatric health prevention (periodicity schedule). IL MedicaidProviderManual PEM AdultPHGsForProviders.pdf
These guidelines cover preventative pediatric care from birth to adolescence. From health history to measures, developmental/behavioral screens, physical exams to procedural tests, and oral health.
L., D., & J. Rourke (2017). Rourke Baby Disc http://rourkebabyrecord.ca/
This site is about the Rourke Baby Record (RBR). Guidelines for well-baby and child care are provided by the RBR.
Final Exam Review (Word document)
Lab Ethical Concerns
Getty Images/Maskot
The wishes of a patient or a family may conflict with evidence, personal experience, or professional judgment. An ethical issue may arise. What do you do in these cases?
This lab assignment will examine particular circumstances and evidence-based practice standards.
Prepared
Examine your instructor’s situations for this week’s Assignment. Your situations are in the classroom’s “Course Announcements” section.
Based on the examples:
Reflect on one scenario from this course.
What information about the patient must be collected through health exams and diagnostic tests?
Consider your role as an APRN. Examine the scenarios’ evidence-based practice standards and ethical considerations.
The Lab Task
Ace my homework – Write a one-page narrative (not a formal document) describing the patient’s health assessment data (include the scenario number). Explain your response as an APN utilizing evidence-based practice recommendations and ethical issues. Justify your response using at least three recent evidence-based references.
Week 11 Day 6
Submit your Task.
Sem.11 Case Study
on Feb 3, 2020 7:57:16 EST
Case 1: A-H
STUDY 1 A 5-year-parents old’s took him to his pre-kindergarten physical exam. His parents oppose all immunizations.
Case #2: I-Q Last names
CASE 2 A 49-year-old cancer patient with advanced stage was admitted to the ER with cardiac arrest. Her spouse and child rode in the ambulance.
Case #3: R-Z
CASE 3 A 27-year-old guy with Crohn’s disease was taken to the ER with a severe flare-up. He explains that he has been unable to afford his meds for some months and is anxious about future treatment expenditures.
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Case Study Preparation
Student’s Name
Institutional Affiliation
Course Number and Name
Instructor’s Name
Date
Case Study Preparation
Homework help – Summary
The case, “No Laughing Matter” illustrates the story of a 22 years old Dante. He went through different interviews before working for Bedrock Communication (Dickmeyer & Dickmeyer, n. d.). In their outlook, managers fear that his confidence may be perceived as part of arrogance. The case study presents a key issue about Dante, which is skipping a crucial and needed phase in the role development process. The stage is encompassed in the socialization process that can track the progression of a person through a company’s social environment (Richmond, McCroskey, & Powell, 2013). The case also illustrates a campaign that failed for a new “Male Enhancement” drug. Some of the actions that can help one deduce the character of Dante include him forming friendships with colleagues early on in his job, making mean comments during the Christmas party, winning the New Employee of the Year Award, and meeting with the CEO Emmett who did not work as anticipated (Dickmeyer & Dickmeyer, n. d.). At some point in the case study, coworkers are seen to be distancing themselves from Dante. One underlying issue that is quite evident in this case is the manner in which assimilation involving progressive behavioral and cognitive processes are incorporated into organizations (Richmond et al., 2013). At one point, the company where Dante works values the cultural and human resources process towards assimilation. One can see this in the inference that although the interview process is deemed as picky and quite exhaustive, the company is looking for the best-fit candidates to fill the available positions. The case of Dante is an illustration of an individual who transitions through stages of the socialization process.
Evidence and interpretation log
Evidence( Interpretation of the background as written in the case study- Your summary) Interpretation(Concepts from the chapter)
Some of the actions that can help one deduce the character of Dante include him being able to form friendships with colleagues early on in his job Basic principle: The socialization function of communication
In-depth: New employees are required to successfully socialize and integrate into the new organization if they are to thrive and grow (Dickmeyer & Dickmeyer, n.d.).
Despite any impressive work ethics, socialization is often the key to survival. It literally denotes how well one thrives in the establishment.
Basic Principle: Informal communication network
In-depth: Successful integration into the social function allows new employees to gain access to the lucrative informal communication that caries all the scale but rumors ((Dickmeyer & Dickmeyer, n.d.)
Being properly socialized assists the employee in understanding the crucial information needs. Through socialization, the employee is preview to the back scenes who plays golf with those who frequent lunches.
At some point in the case study, coworkers are seen to be distancing themselves from Dante.
Basic Principle: Attitude Homophily
In-depth: Homophily refers the extent to which members of the same group have the same attitudes and beliefs towards work. It provides the foundation upon which strong work relationships are built when such strong ties are built between colleagues. It translates to interpersonal trust, effective team work, and collaboration.
Conversely, homophily is considered the general enemy of diversity.
How assimilation involving progressive behavioral and cognitive processes is incorporated into the organization. Basic principle: Defensiveness
Certain defensive behaviors and atmospheres in the organization create barriers to effective communication.
Messages of neutrality from employees and colleagues can push other workers to be eerily defensive.
Problem #1: The socialization function
Communication, in its very essence, plays a crucial role in the organization. One of the major functions of communication is that it serves as a way for employees to socialize. Richmond, McCroskey and Powell (2013) argue that socialization determines whether an individual thrives or shrivels in an organization. It determines the future and longevity of the individual in the said institution. However, it does not denote being friends and buddies with everyone. Rather, it suggests being integrated into the communication channels in the organization to sufficiently navigate the ecosystem, which is the workplace. Hence, the socialization function teaches the employees who play golf, those with frequent lunches, people protected, and those promoted. Increased socialization results and translates into better access to the informal communication channels. Some of the channels include official grapevine that contains the scuttlebutt rumors as aptly referred to by Richmond et al. (2013). In this case, Dante has excellent socialization skills and access to the informal networks. However, the links to the two groups are severed when he makes comments that do not sit well with the creative team during the Christmas roast. Dante finds himself on the defensive side after being outset from his social group at work. Inadvertently, this cuts him off from the informal communication links. As soon as the situation happened, Dante’s work and progress started slowing down. The creative team no longer trusted him. Instead, they started questioning the analysis of his consumer data, including delaying the projects that he was working on. He no longer fit in the organization, and suggestions on headhunters started coming in. Therefore, social links play a crucial role in the organization and can be the difference between longevity in an organization or not.
Problem # 2: Lack of Attitudinal Homophily
In the work environment, people tend to gravitate towards those whom they are alike or people with whom they share similarities. Richmond, McCroskey and Powell (2013) posit that the more similar two people are, the more likely they are to communicate with each other and the more likely that their communication channels with be effective and successful. The definition espouses the principle of homophile. By extension, people will always seek out those who are more like them or those who are more like their actions and behavior. Richmond, McCroskey and Powell (2013) claim homophile is one of the most powerful communication principles due to its pancultural nature. The word homo refers to items that come from the same category. Attitudinal homophily is essentially perceptual in nature, meaning that it is the degree to which one individual perceives another person to share his or her attitudes and beliefs. Attitudinal homophily is especially important in the organizational context as it provides the foundation upon which strong work relationships are built. When such strong ties are built between colleagues, it translates to interpersonal trust, effective teamwork, and collaboration.
Homophily is considered the general enemy of diversity. Employees who may have a stark difference in personalities often find themselves in conflict, which directly translates into minimal work cohesiveness, including little teamwork and cooperation. For instance, Dante and the creative team lack attitudinal homophily. Dante fabricated homophily with the organization and the creative team. In their initial outlook, managers feared that Dante’s confidence might be perceived as part of arrogance. They also feared that his strong competitive personality would hamper him from working as a team player. He acknowledged that at the time, he would be misunderstood for his self-assurance, and he assured them that he would be a team player. However, this was not the case for Dante in his review with Emmett, where it was stated, “If you switch up the letters in the team, you will find the word me”. Furthermore, he felt that not only was the data from the male enhancement flawed but also that he had not come up with the pathetic pitch. Therefore, he was not to be blamed for the failed campaign. The lack of attitudinal homophily, as seen in the case, resulted in Dante’s social isolation from the group and being cut from the informal organization communication channels.
Problem # 3Defensiveness
Conflicts often occur in many organizations. Presumably, the evidence of conflict can result in defensive actions among the accused. Richmond, McCroskey and Powell (2013) revealed that presumably defensive messages are often seen as barriers to effective communication as they create anxiety and hostility, leading people to be unwilling to communicate. In most cases, defensive atmospheres often occur when employees feel threatened and intimated and do not trust others in the organization. However, there are four types of messages that presumably initiate defensiveness. The messages of neutrality at Bedrock Communications forced both Dante and the creative team to be defensive. Richmond et al. (2013) hold that the message of neutrality refers to no message. It is when employees in the work environment simply start to ignore others. Such kind of behavior, in its very essence, may lead workers to become defensive. People in their very essence want to the recognized and not treated as objects with little or no inherent value that can be replaced. While management acknowledges Dante had good efforts and he was granted employee of the year award, his friends and colleagues from the creative team seemed oblivious to it. Nobody mentioned it at work or even at bowling or happy hour. Contrary to happier times, Dante felt ignored. The non-messages or messages of neutrality from the creative team led Dante to be highly defensive in his review with Emmett. Rather than focusing on teamwork, Dante constantly insisted that there was me in the team.
Recommendations
For many employees, career longevity in a field that they love if often their main goal. However, the lack of effective communication can hamper the fulfillment of this objective. For Dante, to effectively stay at Bedrock Communication, he should get back into the social circle. As Emmett notes, there is no me or I in team work. Cultural analysis reveals that the organization values teamwork more than it does to individual stars. With this in mind, Dante should first offer a heartfelt apology to the creative team. This is one of the major ways to get back into the social function as well as gain access to the informal communication channels. Similarly, he should learn various conflict resolution mechanism to enable him to deal with future altercations
Moreover, Dante should adopt emotional intelligence. According to Khalili (2014: 2024 – Essay Writing Service. Custom Essay Services Cheap), emotional intelligence is vital in the workplace since it helps in the self assessment of employees and assists in solving conflicts. In today’s work environment, emotional intelligence is far more favored compared to increased IQ levels. People with higher emotional intelligence levels have been shown to perform better, make better informed decision, and solve conflicts faster and in more creative ways. Emotional intelligence will help Dante navigate the social scene with much more ease by enabling him to understand the alliances he needs to form. He will also learn how to be a team player and appreciate other people’s efforts in various teams.
Overall, communication plays a critical role in the central functioning of any organization. The key functions of communication include informing, socializing, and integrating. Socialization is crucial for employee’s survival. Furthermore, it opens informal channels of communication that the workers may not have had access to. On the other hand, employees always gravitate and communicate with people whom they share similarities. Hence, attitudinal homophily plays a crucial role in ensuring cohesiveness, teamwork, and cooperation. The presence of diversity can result in a lack of attitudinal homophily, which causes overall defensiveness. One of the major ways to combat this problem is through the development of emotional intelligence. It ensures that employees are not only aware of their actions and emotions but also those of others. Hence, they can use this information to make key decisions that will avoid a breakdown in communication.
References
References
Dickmeyer, B. L. & Dickmeyer, G. S. (n. d.). No laughing matter. Case Study in Nursing Health.
Khalili, A. (2014: 2024 – Essay Writing Service. Custom Essay Services Cheap). The role of emotional intelligence in the workplace: A literature review. International Journal of Management, 29(3), 355.
Richmond, V. P., McCroskey, J. C., & Powell, L. (2013). Organizational communication for survival. Pearson Higher Ed.
