Ethical Concerns in the Case of a 49 Year-Old Woman with Advanced Cancer Admitted with cardiac Arrest
The case study chosen is that of a 49 year-old female with a history of advanced stage cancer now admitted in the ED with cardiac arrest. According to Ball et al. (2019), the health assessment information for her diagnosis would include subjective as well as objective information. Because she is indisposed, it is her husband who is accompanying her who would be the historian for the subjective information. This information includes the chief complaint that the lady had before she went into cardiac arrest, the history of presenting illness (the onset, duration, characteristics of symptoms, alleviating factors, aggravating factors, severity, and so on), any drugs she is currently taking, social history, family history, past medical history, allergies known, and a review of all body systems. The objective information needed to complement the subjective information in diagnosis includes general assessment including vital signs, examination of the cardiovascular and respiratory systems, and diagnostics. The diagnostics would be a full blood count and differentials, ECG, and an X-ray of the chest (hammer & McPhee, 2018). These would assist in making the diagnosis. Ethical Concerns on Lab Assignment Essay Example
Being an advanced practice registered nurse or APRN clinician, I would be interested in knowing if the 49 year-old had given anyone in the family medical powers of attorney or MPOA (Fine, 2020). If that is not the case, I would be interested in knowing if there was any advance directive (given the history of advanced cancer) directing that there should be no resuscitation or a do-not-resuscitate (DNR) order (Osinski et al., 2016). Doing this preserves the patient’s right to the bioethical principle of autonomy in which they decide the course of their care (Haswell, 2019). If there was a DNR advance directive, no active intervention will be undertaken (Tingle & Cribb, 2014). But if there was no DNR directive but a MPOA is present, the relative who has it will be asked to make a decision. In all this, the APRN will remain the patient’s advocate (ANA, 2015; Fowler & ANA, 2015) and do what is best for the patient as dictated by the bioethical principle of beneficence and nonmaleficence (Haswell, 2019).
References
American Nurses Association [ANA] (2015). Code of ethics for nurses with interpretive statements. Author.
Ball, J., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2019). Seidel’s guide to physical examination: An interprofessional approach, 9th ed. Elsevier.
Fine, L.E. (February 14, 2020). End of life decisions: Powers of attorney & living wills. https://www.lawpracticetoday.org/article/end-life-decisions-powers-attorney-living-wills/
Fowler, M.D.M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with interpretive statements: Development, interpretation, and application, 2nd ed. American Nurses Association. Ethical Concerns on Lab Assignment Essay Example
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 7th ed. McGraw-Hill Education.
Haswell, N. (2019). The four ethical principles and their application in aesthetic practice. Journal of Aesthetic Nursing, 8(4), 177-179. https://doi.org/10.12968/joan.2019.8.4.177
Osinski, A., Vreugdenhil, G., de Koning, J., & van der Hoeven, J.G. (2016). Do-not-resuscitate orders in cancer patients: A review of literature. Supportive Care in Cancer, 25(2), 677–685. http://dx.doi.org/10.1007/s00520-016-3459-9
Tingle, J., & Cribb, A. (2014). Nursing law and ethics, 4th ed. Wiley Blackwell
Assignment 1: Lab Assignment: Ethical Concerns
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. Please see the “Course Announcements” section of the classroom for your scenarios.
• Based on the scenarios provided:
o Select one scenario, and reflect on the material presented throughout this course.
o What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
o 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
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.
We will be discussing ethical issues in your final assignment. Your paper is NOT in SOAP format. You will be discussing the issue and how you would address the issue as an advance practice nurse. Choose on of the scenarios below and provide detail on what information you would still need to know, and rationale on how you would handle the situation.
Scenario #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.
Scenario #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. Ethical Concerns on Lab Assignment Essay Example