Summary
The patient, Gloria Smart is 55 years of age. She and her fiancé are interested in having a child. The patient has undergone coronary angioplasty and suffers from hypertension. She is currently on medication to lower her blood pressure, cholesterol levels and to prevent heart attacks. Discussion Post Essay Example
Differential diagnosis
While the patient’s medical history shows no contraindications of IVF, her medical history suggest that the pregnancy process may put her at risk (Silversides et al., 2018).
Justification for the diagnosis decision
Pregnancy will require the patient’s heart to worker harder. This is not ideal for the patient’s heath considering she has received a received a cardiac stent. The pregnancy may therefore worsen her heart disorder and hypertension. The risk of death to either the patient or the fetus increases when the heart condition was severe before the onset of pregnancy (Silversides et al., 2018).
Treatment Plan
For her heart condition, the patient will remain on her current medications (Zocor, Plavix, and Lisinopril). The patient will be advised of the risks of getting pregnant at her age and given her medical history. She will then be referred to psychiatrist for consoling. It is advised that her fiancé accompany her.
Evidence-based Research
Involuntary childlessness has been linked to depression. If the depression goes on for more than two months, it is likely to negatively affect the patient’s life. It is therefore important to work with a caring and impartial counselor where they can admit their feelings with no fear of judgment and finding ways to move forward (Fieldsend, 2018). This has been found to produce positive outcomes among patients with depression due to involuntary childlessness. Discussion Post Essay Example
Resources did you use to meet your best practice guidelines?
PsycArticles (EBSCO) is a peer reviewed resource for both scientific and scholarly articles in psychology. It contains numerous articles from the American Psychological Association as well as organizations allied to it. This resource helps medical professionals in meeting best practice guidelines.
Issues for the Case Study
Ethical issues: The most prominent ethical issue is deprivation of liberty. Deprivation of Liberty Safeguards (DoLS) however ensure that people are protected from care arrangements that deprive them of their liberties.
Psychological issues: As stated above, the most notable psychological issue is depression resulting from involuntary childlessness with the recommended treatment being counseling.
Physical issues: The patient has a cardiac stent and suffers from mild hypertension both of which may be exacerbated by a pregnancy at her age.
Financial issues: The costs of IVF and any related complications may amount to between $12,000 and $14,000 for one cycle (Herndon, 2019).
References
Fieldsend, M. (2018). What is it like being involuntarily childless? Searching for ways of understanding from a psychological perspective. In Voluntary and involuntary childlessness. Emerald Publishing Limited.
Herndon, C. N. (2019). Need for expanding insurance coverage for in vitro fertilization in the United States. Fertility and Sterility, 112(1), 37-38.
Silversides, C. K., Grewal, J., Mason, J., Sermer, M., Kiess, M., Rychel, V., … & Siu, S. C. (2018). Pregnancy outcomes in women with heart disease: the CARPREG II study. Journal of the American College of Cardiology, 71(21), 2419-2430. Discussion Post Essay Example
Rubric Detail
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Name: NRNP_6552_Week9_Case_Study_Discussion_Rubric
Excellent Point range: 90–100 |
Good Point range: 80–89 |
Fair Point range: 70–79 |
Poor Point range: 0–69 |
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Main Posting: Response to the case study discussion questions includes appropriate diagnoses with explanations of appropriate diagnostic tests and treatment options as directed, is based on evidence-based research where appropriate, and is incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources. | 40 (40%) – 44 (44%)
Thoroughly responds to the discussion question(s). Post includes approprite diagnoses including explanations of appropriate diagnostic tests and treatment options. Incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources, with no less than 75% of post the post having exceptional depth and breadth. Supported by at least 3 current credible sources. |
35 (35%) – 39 (39%)
Responds to most of the discussion question(s) Post includes approprite diagnoses with explanations of appropriate diagnostic tests and treatment options. Somewhat incorporates syntheses representative of knowledge gained from the course readings for the module and current credible sources with no less than 50% of the post having exceptional depth and breadth. Supported by at least 3 credible references. |
31 (31%) – 34 (34%)
Responds to some of the discussion question(s). Post contains incomplete or vague diagnoses or explanations of appropriate diagnostic tests and treatment options. Is somewhat lacking in synthesis of knowledge gained from the course readings for the module and current credible sources. Post is cited with fewer than 2 credible references. |
0 (0%) – 30 (30%)
Does not respond to the discussion question(s). Post contains incomplete diagnoses or explanations of appropriate diagnostic tests and treatment options, or diagnoses and/or explanations are missing. Lacks synthesis gained from the course readings for the module and current credible sources. Contains only 1 or no credible references. |
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Main Posting: Writing | 6 (6%) – 6 (6%)
Written clearly and concisely. Contains no grammatical or spelling errors. Further adheres to current APA manual writing rules and style. |
5 (5%) – 5 (5%)
Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style. |
4 (4%) – 4 (4%)
Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors. |
0 (0%) – 3 (3%)
Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. |
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Main Posting: Timely and full participation | 9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation. Posts main discussion by due date. |
8 (8%) – 8 (8%)
Posts main discussion by due date. Meets requirements for full participation. |
7 (7%) – 7 (7%)
Posts main discussion by due date. |
0 (0%) – 6 (6%)
Does not meet requirements for full participation. Does not post main discussion by due date. |
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First Response: Post to colleague’s main post that is reflective and justified with credible sources. | 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
7 (7%) – 7 (7%)
Response is on topic, may have some depth. |
0 (0%) – 6 (6%)
Response may not be on topic, lacks depth. |
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First Response: Writing |
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in Standard, Edited English. |
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in Standard, Edited English. |
4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
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First Response: Timely and full participation |
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
3 (3%) – 3 (3%)
Posts by due date. |
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
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Second Response: Post to colleague’s main post that is reflective and justified with credible sources. |
9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. |
8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. |
7 (7%) – 7 (7%)
Response is on topic, may have some depth. |
0 (0%) – 6 (6%)
Response may not be on topic, lacks depth. |
||
Second Response: Writing |
6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in Standard, Edited English. |
5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in Standard, Edited English. |
4 (4%) – 4 (4%)
Response posed in the discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited. |
0 (0%) – 3 (3%)
Responses posted in the discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited. |
||
Second Response: Timely and full participation |
5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation. Posts by due date. |
4 (4%) – 4 (4%)
Meets requirements for full participation. Posts by due date. |
3 (3%) – 3 (3%)
Posts by due date. |
0 (0%) – 2 (2%)
Does not meet requirements for full participation. Does not post by due date. |
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Total Points: 100 | ||||||
Unfolding Case Study 1:
Issues in Advanced Nursing Practice
55 year old female
Image of a 55 year old female
Background
Gloria Smart is a 55-year-old female who presents to your office today for regular gyn care. You read her medical history and note she received a cardiac stent at age 50, has mild hypertension, and is on Zocor, Plavix, and lisinopril. Surgical history is remarkable for tonsils as a child and bunion surgery. She works full time, by choice, because it “makes me feel young.” She is up to date with colonoscopies. Gyn history normal pap history, last DXA within normal limits, normal mammogram. BMI is 26. First menses age 14 and menopause age 52. She works out at her local gym 5 days a week. Social history is negative for tobacco and recreational drugs. She has an occasional glass of wine. She has never married and has been with her current partner for 2 years and will be getting married in 2 months. She has never been pregnant, and her partner has never had a child.
Decision Point One
Gloria relates as you start to talk to her that she and her fiancé have been talking about it, and they would like to have a child. She wants a referral and some guidance.
What anticipatory guidance should you consider?
She is too old and should focus on maintaining her health and refer her for counseling.
Her medical history doesn’t show any contraindications to IVF.
She has some things in her history that she needs to consider.
She should have her fiancé checked before she does anything.
Case Study Discussion: Working Through Ethical Dilemmas and Other Issues in Advanced Nursing Practice
The Discussion for this week is to provide you an opportunity to discuss with your colleagues the case studies presented in the interactive media program. These case studies involve ethical dilemmas or other issues encountered in advanced nursing practice. Discussion Post Essay Example
Photo Credit: Wave break media Micro / Adobe Stock
By Day 3
To prepare:
By Day 6
Respond to at least two of your colleagues’ posts (from a different group) on two different days and provide additional insight that might be useful and appropriate for the issue addressed. Use your learning resources and/or evidence from the literature to support your position.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information