NUR 3066 RN BSN Program Ethical Legal Dimensions Essay

1 Homework 1 Student Name RN-BSN Program, St. Petersburg College NUR 3066: Health Assessment & Physical Appraisal Professor Name Month ##, #### APA 7TH EDITIION DISCLAIMER: This sample assignment is provided as a courtesy. This is an example of a well-written homework assignment. It is NOT a perfect. You are expected to use the scenarios and questions provided in your edition of the homework and APA formatting from the current edition of the APA manual. Do NOT print or distribute copies. Do NOT copy or use this author’s words in your own paper. Areas have been blacked out as this sample is only intended to give you an idea of the flow of content. 2 Question 1: Based on initial findings, ethical-legal issues regarding client autonomy and mandatory reporting are identified. According to the American Nurses Association (ANA; 2015), the nurse ethically is responsible for respecting and promoting client autonomy; however, the nurse is also responsible for considering competency and ensuring safety. The client has a history of refusing treatment, which is his right; however, initial findings are suggestive of neglect, daily functioning deficits, and possible suicidal ideation or depression. Thus, the client’s autonomy and right to self-determination have to be carefully evaluated in comparison to his functioning, safety, and mental state (Ball et al. 2019, pp. 18). Initial findings of ecchymoses, uncleanliness, and being left alone by caregivers are all indications of possible neglect or abuse. Florida nurses are legally required to report suspected abuse or neglect of any vulnerable adult that has a reduced capability of providing self-care (Florida Department of Children and Families [DCF], 2013). Considering DCF criteria, the client is a vulnerable adult because of his disabilities, age, decreased ability to provide self-care, self-neglect, and possible neglect and abuse by primary caregivers (DCF, 2013). Question 2 Based on the client’s limitations of dyspnea and decreased visual acuity, modifications to the exam are necessary. The client has dyspnea that is exacerbated by exertion and speaking; therefore, additional exam time is needed so activities can be paced. In addition, the client will need sufficient time to answer questions since he experiences dyspnea from excessive speaking. Pacing activities conserves energy and decreases oxygen consumption, which assists to reduce dyspnea and prevent hypoxia (Gulanick & Myers, 2019). Furthermore, modifications for visual acuity deficits are recommended for safety during the exam, especially since the client is wheelchair bound and has a fall history. Vision modifications include providing adequate 3 lighting; encouraging use of vision aids; assisting the client with mobility and transfer; and assessing the environment for possible obstacles to reduce fall risk (Gulanick & Myers, 2019). Question 3 Appropriate healthcare referrals for the client include social services and psychiatry. A social services consult is beneficial because social workers can assist in evaluating and reporting suspected neglect of elders, including self-neglect (Felton & Polowy, 2019). Moreover, a multidisciplinary approach is essential for protecting elders from mistreatment, and social workers are vital members of the multidisciplinary team (National Association of Social Workers, 2015). NUR 3066 RN BSN Program Ethical Legal Dimensions Essay

An additional referral concerning client safety includes obtaining an order for a psychiatric consultation to evaluate the client’s risk for suicide. Behavioral health clinicians can assist with identifying suicide risk and providing continuity of care, which are crucial steps for suicide prevention (The Joint Commission, 2016). Question 4 According to Queensland Health (2019), the Hindu culture places a high emphasis on purity and rituals of cleanliness. Practicing Hindus prefer running water; therefore, a shower takes precedence of the bath. The described patient for this scenario frequently washes her face, which has a direct impact on her condition. The nurse can encourage the patient to be extra careful while washing the face, limiting soap and rubbing. In addition, at least during the course of the illness, the patient could take baths rather than showers. According to the National Library of Medicine (2018), colloidal oatmeal and starch baths could sooth the pain and provide comfort. 4 Questions 5 and 6 Family Member Family Information Siblings JH is a living, 46-year-old male with a history of hypertension (HTN), depression, anxiety, obesity, and substance addiction. Mother BH is a living, 72-year-old female with a history of HTN, stage 1 breast cancer (BRCA) at age 70, and morbid obesity. Maternal grandmother SD was a 72-year-old female at the time of death, and her cause of death was a pulmonary embolism. She had a history of HTN, coronary artery disease (CAD), peripheral vascular disease, obesity, myocardial infarction, and bilateral BRCA in her 50s. Maternal grandfather CD was a 75-year-old male at the time of death. His cause of death was from lung cancer. He was also a severe alcoholic and a smoker from age 16 until time of death. Father JH is a living, 82-year-old male with a history of HTN, carotid stenosis, arteriosclerosis, CAD, and depression. Paternal grandmother FH was age 50 at the time of death, and her cause of death was a result of complications from ovarian cancer metastases. She also had a history of BRCA. Additional medical history is unknown. Paternal grandfather NH was age 65 at the time of death. His death was a result of complications from prostate cancer metastases. Additional medical history is unknown. Describe patterns of illnesses and health risks based on the family history. Identified illness patterns and health risks to the client, a 37-year-old female, include: cardiovascular disease; cancer, specifically breast and ovarian; obesity; and psychiatric disorders, including anxiety and depression and substance abuse/addiction. BRCA is particularly concerning because the client’s mother, maternal grandmother, and paternal grandmother were diagnosed with BRCA, and her maternal grandmother was initially diagnosed in her 50’s. Further questioning of the client reveals that her maternal aunt also had BRCA and ovarian cancer, and died at age 60 from metastases. 5 References American Nurses Association. (2015). Code of ethics for nurses with interpretive statements (2nd ed.). https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/codeof-ethics-for-nurses/ Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). The history and interviewing process. Seidel’s guide to physical examination (9th ed., pp. 1-21). Mosby. Felton, E. M., & Polowy, C. I. (2019). Social workers and elder abuse. http://www.naswal.org/?page=ElderAbuse Florida Department of Children and Families. (2013). Reporting abuse of children and vulnerable adults. https://www.dcf.state.fl.us/programs/abuse/ publications/mandatedreporters.pdf Gulanick, M., & Myers, J. L. (2019). Impaired gas exchange. Nursing care plans, diagnoses, interventions, and outcomes (10th ed., p.175-187). Elsevier. National Association of Social Workers. (2015). NASW recommendations for the 2015 White House conference on aging. http://www.socialworkers.org/practice/agi ng/documents/NASW_Comments_on_2015_WHCoA_Elder_Justice_Policy_Brief_6121 5.pdf National Library of Medicine. (2018). Shingles – aftercare. www.medlineplus.gov/ency/patientinstructions/000560.htm Queensland Health (2019). Healthcare providers’ handbook on Hindu patients. www.health.qld.gov.au/__data/assets/pdf_file/0024/156255/hbook-hindu.pdf The Joint Commission. (2016). Detecting and treating suicide ideation in all settings. Sentinel Event Alert, (56), 1-7. https://www.jointcommission.org/assets/1/ 18/SEA_56_Suicide.pdf Spring HOMEWORK 1 Instructions: Provide complete and concise answers to questions, do not include questions or scenario, and submit to assigned drop box by deadline. Use scholarly writing for all answers. Include APA style title page, citations, and reference list. Use correct grammar, complete sentences, paragraph structure, and professional terms. Use scholarly sources (e.g., textbook, journals, government agencies) less than 5 years old to support answers. Paraphrase content (i.e., rephrase in your own words), cite/reference source, and do not use quotes. Part 1: Agila Laghari is a 65-year old female who presents to your office with a new complaint of right wrist pain after falling at home. Her medical history is significant for rheumatoid arthritis affecting multiple joints and causing extensive joint deformity, weakness, and impaired mobility. In addition, she has been hospitalized for autoimmune-related cardiac complications and heart failure. She is deaf in the right ear. For the past year, she has refused follow-up healthcare visits any additional treatments or medications. She states “I hate living like this. The pain in unbearable. I just want to die in peace”. She was born in India and is a practicing member of the Protestant St. Thomas Christian community. She is essentially wheelchair bound and on supplemental oxygen via nasal cannula. She lives with her adult son and daughter-in-law who are the primary caregivers. Further interviewing reveals that she is often left at home alone for long periods of time while they work; and she injured her wrist when she fell while trying to make herself something to eat. Upon inspection, she is unwashed, smells faintly of urine, and has multiple ecchymoses visible on both arms in various stages of healing. She is very thin and gets short of breath easily with excessive talking and movement. For Ms. Laghari, 1. Describe 2 ethical-legal dimensions and the nurse’s responsibilities related to the client (10 points) 2. Explain 2 modifications based on client limitations that the nurse should make in order to complete a safe, effective, and comfortable physical exam (10 points) 3. Discuss 2 potential healthcare referrals for the client and the need/benefit to the client (10 points) 4. Explain 2 potential cultural and/or spiritual considerations related to care for this client (10 points) Part 2: Find an adult volunteer with sibling(s) who is aware of his/her biological family’s health and complete a family history. Use essay format or place information in a table. A blank table is available to copy/paste. For the volunteer, 5. Complete a history of 3 generations. For each family member, identify initials, gender, alive/deceased, current age/age at death, major illnesses, and cause of death. If unknown, state what is unknown (20 points) 6. Describe patterns of illnesses and genetic health risks based on the family history (25 points) Family Member Family Information (use concise, complete sentences) Sibling(s) Mother Maternal grandmother Maternal grandfather Father Paternal grandmother Paternal grandfather Describe Patterns of Illness and Genetic Health Risks: Scholarly writing (15 points) Copy/paste this table into the same file with the rest of your answers. Use single spacing in tables. Keep all answers in one file. Family Member Family Information (use concise, complete sentences) Sibling(s) Mother Maternal grandmother Maternal grandfather Father Paternal grandmother Paternal grandfather Describe Patterns of Illness and Genetic Health Risks: …