Rubric
Select one scenario,
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
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
A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled.
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.
Ethical Concerns
Student’s Name
Institutional Affiliations
CASE STUDY 3
A 25-year-old woman with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of her condition. She explains that she has not been able to afford her medications for the last few months and is concerned about the costs she may incur for treatment.
Health Assessment
The nurse practitioner should begin the health assessment by collecting relevant subjective, objective, and assessment data before developing her plan of care. The nurse should also identify factors that might hinder the patient from attaining positive health outcomes. Relevant subjective data that should be collected include;
Chief complaint: Obtain the patient’s current symptoms and reason for visiting the clinic.
History of Present Illness (HPI): Record her age and inquire about the duration of her symptoms. The nurse should also seek to understand the last time she obtained treatment for her condition.
Medications/Allergies: Ask the patient whether she is taking any medications and whether she is allergic to certain foods or drugs.
Personal/Social history: Find out whether the patient consumes cigarettes, alcohol, or other illicit drugs. It is also important to ask the patient about her employment status and source of income.
Other histories: Obtain information regarding past medical history, past surgical history, sexual/reproductive history, immunization history, and significant family history (Ball et al., 2015).
Relevant objective data:
In addition to the objective examinations that the nurse would obtain to understand the nature of the patient’s illness, it is also important to conduct general observation to see how the lack of medication has affected her quality of life (Dains et al., 2016).
Assessment:
There is a need to treat the patient for the symptoms and complications caused by Crohn’s disease. Additionally, the patient needs assistance regarding how she can address the cost issue that is preventing her from getting her medications.
Response
The advanced practice nurse is charged with the responsibility of offering the best treatment to the patient to improve symptoms of Crohn’s disease. Additionally, she should eliminate barriers to healthcare access. The nurse should maintain the drug therapy the patient has been using to maximize benefits as a consideration to the ethical principle of beneficence (Raus et al., 2018). Additionally, the nurse should use the right channels to enroll the patient in a health insurance program to help address the cost issue. This move demonstrates that the nurse’s consideration of right-based ethics concerning the patient’s right to health care access (American Medical Association, 2021).
References
American Medical Association. (2021). Promoting health as a human right in the post-ACA United States. AMA Journal of Ethics, 17(10):958-965. doi: 10.1001/journalofethics.2015.17.10.msoc1-1510.
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. Chapter 23, “Sports Participation Evaluation” (pp. 581-593).
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
Raus, K., Mortier, E. & Eeckloo, K. (2018). The patient perspective in health care networks. BMC Medical Ethics, 19, 52. https://doi.org/10.1186/s12910-018-0298-x