Assignment: NURS 6512 Ethics in the Role of Advanced Practice Nurses

Assignment: NURS 6512 Ethics in the Role of Advanced Practice Nurses

Assignment: NURS 6512 Ethics in the Role of Advanced Practice Nurses

Abstract

As Advanced Practice Nurses we are held to an ethical code. We must make every attempt to provide competent patient care while following this code. On the occasions that errors may occur is also our duty to know the ethical implication of disclosure and nondisclosure.

Scenario:

You are working as an advanced practice nurse at a community health clinic. You make an error when prescribing a drug to a patient. You do not think the patient would know that you made the error, and it certainly was not intentional.

Ethical implications of disclosure and nondisclosure.
Legal implications of disclosure and nondisclosure for you and the health clinic.
What you would do
Strategies to avoid medication errors. Assignment: NURS 6512 – Ethics in the Role of Advanced Practice Nurses

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NURS 6512 Week 1 Discussion – Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients:

·        76-year-old Black/African-American male with disabilities living in an urban setting

·        Adolescent Hispanic/Latino boy living in a middle-class suburb

·        55-year-old Asian female living in a high-density poverty housing complex

·        Pre-school aged white female living in a rural community. Nurs 6512 Wk 1 Discussion – Building a Health History.

·        16-year-old white pregnant teenager living in an inner-city neighborhood

To prepare:

With the information presented in Chapter 1 in mind, consider the following:

·        How would your communication and interview techniques for building a health history differ with each patient?

·        How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?

·        What risk assessment instruments would be appropriate to use with each patient?

·        What questions would you ask each patient to assess his or her health risks?

·        Select one patient from the list above on which to focus for this Discussion.

·        Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration. Assignment: NURS 6512 – Ethics in the Role of Advanced Practice Nurses

·        Select one of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the course text, or another tool with which you are familiar, related to your selected patient.

·        Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

Post a 1 page paper APA format  1. a description of the interview and communication techniques you would use with your selected patient.

2. Explain why you would use these techniques.

3 Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient.

4 Provide at least five targeted questions you would ask the patient.

Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 1, “The History and Interviewing Process” (pp. 1–21)

This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.

o   Chapter 26, “Recording Information” (pp. 616–631)

This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.

·        Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 1, “Medicolegal Principles of Documentation” (pp. 1–12 and abbreviations, pp. 18)

o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

·        Deeks, A., Lombard, C., Michelmore, J., & Teede, H. (2009). The effects of gender and age on health related behaviors. BMC Public Health, 9, 213–220.
Retrieved from the Walden Library databases.

This article describes a study that sought to determine the effects of gender and age on health-related behaviors. In the study, the authors also investigated the effects of screening practices, health beliefs, and perceived future health needs.

·        Delpierre, C., Lauwers-Cances, V., Datta, G. D., Berkman, L., & Lang, T. (2009). Impact of social position on the effect of cardiovascular risk factors on self-rated health. American Journal of Public Health, 99(7), 1278–1284. Retrieved from the Walden Library databases.

This study assessed the influence of education level on the association between self-rated health and cardiovascular risk factors. The authors explain their methods and results, and they provide recommendations for similar studies in different countries and cultures.

·        Lee, D. W., Neumann, P. J., & Rizzo, J. A. (2010). Understanding the medical and nonmedical value of diagnostic testing. Value in Health, 13(2), 310–314.
Retrieved from the Walden Library databases.

The authors of this article detail their attempts to develop a framework for defining the potential value of diagnostic testing. The authors also discuss the implications of their framework for health care delivery systems.

·        University of Michigan Medical School. (2003). Geriatric functional assessment.
Retrieved from http://www.med.umich.edu/lrc/coursepages/m1/HGD/GeriatricFunctionalAssess.pdf

This article provides an exercise that emphasizes accurate functional status assessments and effective communication with older patients. The authors recommend tools and techniques to be used when caring for older patients. Assignment: NURS 6512 – Ethics in the Role of Advanced Practice Nurses

Note about Uploading Media: Please refer to the Kaltura Media Uploader page located in the course navigation menu.. The documents on this page provide guidance on how to upload media for your Health Assessment Videos assignments for this course.

·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin’s diagnostic examination (9th ed.). New York, NY: McGraw- Hill Medical.

o   Chapter 2, “History Taking and the Medical Record” (pp. 15–33).

NURS 6512 Week 2 Discussion 1

Assessment Tools and Diagnostic Tests

The Assessment Tool or Diagnostic Test Selected

Mammogram Validity and Reliability

In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.” Assignment: NURS 6512 – Ethics in the Role of Advanced Practice Nurses

Case 2

TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0. NURS 6512 Week 2 Discussion Assignment

Case 3

MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.  NURS 6512 Week 2 Discussion Assignment

To prepare:

· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

· Select one of the three case studies. Reflect on the provided patient information.

· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

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Links:

NURS 6512 Week 2 Discussion 2

Diversity and Health Assessments

Cultural Factors Associated

Sensitive Issues when Interacting with the Patient

Targeted Questions

NURS 6512 Week 3 Initial Post

NURS 6512N-26: Advanced Health Assessment

INITIAL POST

Health Issues and Risks of Children’s Weight

5-year-old girl of normal weight with obese parents

Information Needed for Weight Assessment

Strategies for Healthy Behaviors

References. Assignment: NURS 6512 – Ethics in the Role of Advanced Practice Nurses

NURS 6512 Week 4 Initial Post

NURS 6512N-26: Advanced Health Assessment

INITIAL POST

Skin Conditions and their Differential Diagnoses

Graphic #2

Graphic #5

References