Ethical Theories And Decision-making Models

Determine ethical theories and decision-making models appropriate for healthcare providers to use for providing a safe, quality healthcare experience for the patient  Analyze the role of professional regulation, the standard of care, and codes of ethics in determining healthcare providers’ wide-ranging accountability to self, their profession, their patients, and the public 

Prompt In this project, you will analyze a court case involving medical malpractice. Using your analysis of the case, you will address the facts pertaining to the medical standard of care, breach of care, and causation. Further, you will use the facts from the original case to identify an ethics issue, determine an ethical theory that would help provide a safe and quality healthcare experience for the patient, apply a clinician–patient shared decision-making model, and augment or vary the facts of the case to change the outcome. 

You will use the following case to analyze for Final Project I: 

 Surgery: Iturralde v. Hilo Medical Center USA 

Specifically, your case study must address the following critical elements: 

I. Introduction: A. Summarize the selected case, including information on the stakeholders involved, the problem, and the time period the incident occurred. 

II. Medical Malpractice Component: In this section, you will evaluate the case to address the legal components, the malpractice policies similar to this case, and the standard of care given to the patient and how it was breached. Then, you will draw connections to how this malpractice case impacted stakeholders and healthcare consumers outside of the case. A. Explain the key legal components of the case, including the nature of the issue and the rules that applied. B. Determine relevant malpractice policies in place for addressing the issues within the case. C. Analyze the malpractice case for the standard of care provided to the victim. Be sure to apply what the law states about standard of care to support whether or not it was breached in the case. D. Analyze how the malpractice case would impact healthcare consumers from different cultural backgrounds. For example, would this case have a similar impact on a person from a culture different from the one in the case? How could this incident change the views of these healthcare consumers toward the healthcare system? E. Assess the malpractice case for accountability based on its severity. To what extent was the healthcare provider held accountable? 

III. Ethical Component: In this section, you will evaluate the case to identify the specific ethical issues and determine ethical theories and shared decision- making models that would help resolve the issue and provide a safe, quality healthcare experience. Then, you will propose and defend ethical guidelines for healthcare providers to follow in order to avoid future incidents. A. Describe the ethical issues that led to the malpractice case and explain why the issues are credited with causing the incident. Support your response with research and relevant examples from the case. B. Describe an ethical theory that would help resolve the issue and provide a safe, quality healthcare experience for the patient. Support your response with research and relevant examples from the case. C. Select a physician–patient shared decision-making model and explain how it would provide a safe, quality healthcare experience for the patient D. Propose ethical guidelines that would have helped prevent the incident and would help the organization prevent future incidents. E. Defend how your proposed ethical guidelines will hold healthcare providers accountable to themselves, their profession, their patients, and the public. 

II. Recommendations: In this section, you will utilize the knowledge you gained from your malpractice and ethical analyses to recommend and defend strategies that would help improve medical practices and avoid future liability. A. Recommend preventative strategies the healthcare provider could implement to avoid liability in the future. B. Defend how your recommended preventative strategies would assist the healthcare provider in avoiding liability and provide a safe, quality healthcare experience for the patient. 

The Role Of A Nurse Leader As A Knowledge Worker. (APA STYLE)

Reflect on the concepts of informatics and knowledge work as presented in the Resources. Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

Benchmark – Gospel Essentials

In this assignment you will summarize and analyze the essential elements of the Christian worldview and reflect on implications for your own worldview.

Write a 1,250-1,500-word essay using at least two course resources (textbook, lectures, the Bible) and at least two other sources from the GCU Library to support your points. Remember, the Bible counts as one reference regardless of how many times you use it or how many verses you cite.

Begin your paper with an appropriate introduction, including a thesis statement to introduce the purpose of the paper.

Organize your paper with the following sections using the seven underlined titles for subheadings.

The Christian Worldview: Describe the beliefs of the Christian worldview with regard to the following components corresponding to Topics 2-5. Write at least one paragraph for each component using the underlined title for a subheading.

God: What is God like? What are God’s characteristics? What is his creation?

Humanity: What is human nature? What is human purpose? What is the root cause of human problems?

Jesus: What is Jesus’ true identity? What did Jesus do? Why is Jesus’ identity and work significant for the Christian worldview?

Restoration: What is the solution to human problems according to the Christian worldview? What role do grace and faith play in Christian salvation? How do Christians think that the transformation of self and society happens?

Analysis: Analyze the Christian worldview by addressing each of the following questions:

  1. What are the benefits or strengths of Christian belief?
  2. What is troublesome or confusing about Christianity?
  3. How does Christianity influence a person’s thinking and      behavior?

Reflection: Reflect on your worldview by answering one of the following questions:

  1. If you are not a Christian, what similarities and      differences are there between your worldview and the Christian worldview?
  2. If you are a Christian, how specifically do you live      out the beliefs of the Christian worldview?

Conclusion: Synthesize the main points, pulling the ideas of the paper together.

References

Prepare this assignment according to the guidelines found in the GCU Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Strategic Points For The Prospectus, Proposal, And Direct Practice Improvement Project

10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project

Week Two Assignment Instructions DNP 820

Please read the instructions thoroughly there are strict requirements

 I need at least 10 different articles/literature reviews added to the ones in the 815 attachment. I have also included the chart to be filled out All within 5 years and pertinent to the subject. 

Tutor MUST have a good command of the English language

The Rubric must be followed, and all the requirements met

This is a thorough professor, and she has strict requirements

I have attached the PICOT and the first 10 points (DNP 815) assignment. This is a continuation of that assignment. Please read the attachments

The following needs to be addressed:

Please note the followings: The introduction and the literature review are complete and thorough. The problem statement is written clearly PICOT is clear and very good Sample: 

· How will you determine the sample size? 

· What are the inclusion/exclusion criteria of the subjects? Methodology: Why is the selected methodology is appropriate? Please justify! 

· Data collection approach needs to be clear. How will you collect your data? What is needed here is to describe the process of collecting data form signing the informed consent until completing the measuring. 

· Data analysis-What test will you use to answer your research question? 

Clinical/PICOT Questions:  

“In adult patients with CVC at a Clear Lake Regional Medical Center, does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to standard care over a one-month period?”

P: Patients with Central Venous Catheters

I: Staff re-education related to Hygiene of the hub

C: Other hospitals

O: Reduce probability of CLABSIs

T: Two months

“In Patients > 65 years of age with central line catheters at a Clear Lake Regional Medical Center, how does staff training of key personnel and reinforcement of central line catheter hub hygiene after its insertion, along with the apt cleansing of the insertion site, before every approach compared with other area hospitals, reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections) over a one-month period?”

P: Patients > 65 years of age with a Central line

I: Staff training and reinforcement of Central Catheter, Hub Hygiene 

C: Other area hospitals 

O: Reduce probability of CLABSIs

“In adult patients, with define CVC (CVC), does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to pre and post-intervention assessments 

1. I used central Missouri as an example, replace with a description of your site. 

2. While you might be interested in CLASBI rates as a primary variable, there are other patient outcomes that would also be important to consider

3. Ensure you can find validity and reliability measures on CLASBI rates if you cannot, we need to determine another question to help

4. How are your two comparison groups different, as they are currently stated the groups seem very much the same, could you state, standard care instead of pre and post intervention assessments? 

5. One month is the longest time you can use for a prospective project

Please note the following regarding the instructors grading

IMPORTANT INFORMATION ABOUT MY GRADING STYLE

As you prepare for written papers and manuscripts I’d like to give you some details about my grading style. I provide significant feedback on your papers, this is because I believe you should be working towards improving your writing so that at the end of this program you are able to successfully write your DPI project. In order to write well, you need feedback and you need to review that feedback and make progress on the next written work. To that end I always grade accordingly. This means that if I provide feedback one an item (for example APA format of your reference page) I expect that this will be improved on the next written submission. Otherwise I will deduct additional points. In addition, some other criteria to get down pat now. References should always

1. Be current, no older than 5 years that means 5 years from your proposed graduation date (2014-2019). Otherwise you will have to redo everything in DNP 955.

2. Be primary sources. You can no longer cite Young declared literary war in 1956 (as cited by Brown 2006). You must cite Young 1956. That means go find that paper and read it and make sure that you agree with what Brown said. What if you don’t agree due to some very valid points? Then the literary war is not what occurred, but instead you have concerns regarding point ____, ____, and ____.

3. You may no longer cite textbooks, they are 1) secondary sources and 2) not current enough, and please use peer reviewed manuscripts.

One more item that is not a reference. You may not use direct quotes any longer. There is no need. This may be difficult at first, but you are moving towards a different type of writing. This is manuscript writing (scientific writing). Scientific writing is terse, clear, and concise. No frilly words. In order to avoid the use of direct quotes you will synthesize the literature. There is a great resource for synthesizing the literature under Resources – Add-ons. These are also some other great writing resources there.

Details:

 

In the prospectus, proposal, and scholarly project there are 10 strategic points that need to be clear, simple, correct, and aligned to ensure the research is doable, valuable, and credible. The 10 strategic points emerge from researching literature on a topic that is based on or aligned with the learner’s personal passion, future career purpose, and degree area. These 10 points provide a guiding vision for DPI Project. In this assignment, you will continue the work begun in DNP-815, working on your draft of a document addressing the 10 key strategic points that define your intended research focus and approach.

General Requirements:

Use the following information to ensure successful completion of the assignment:

  • Locate      the “The 10 Strategic Points for the      Prospectus, Proposal, and Direct Practice Improvement Project” that      you completed in DNP-815.
  • Doctoral      learners are required to use APA style for their writing assignments. The      APA Style Guide is located in the      Student Success Center. An abstract is not required.
  • This      assignment uses a rubric. Please Review the rubric prior to the beginning to become familiar with the      expectations for successful completion.
  • You      are required to submit this assignment to Turnitin. Please refer to the      directions in the Student Success Center.

Directions:

Use the “The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project” resource to draft statements for each of the 10 points for your intended research study.

You worked on this last in DNP 815. Pick up from where you left off (if you transferred in and did not complete this, you will have to begin fresh). Please include a copy of your last instructor feedback when you submit this assignment. You can either copy and paste the instructor feedback into your current paper (as an appendix and clearly marked); or upload two separate papers. I expect significant improvement from your last submission.

Please review the 10 Strategic Points document for additional instructions and an example. Add references to this document, I suggest 5-10 at this point. You need to realize that your literature review chapter will need at least 50+ articles by the time you get to DNP 955, so work on expanding your literature search each week, to include more and more to this paper as you move through each course. If you cannot locate 50+ articles you can ask your faculty for assistance or chose a different topic.

For the methodology and design sections. Methodology should cover the broad methods you plan to use (qualitative, quantitative, or mixed methods). The design portion will then go into more detail and discuss the design (i.e. correlational, cross-sectional, pre/posttest, etc.). Describe each and explain why your chosen methodology and design are appropriate to your topic and project questions. You may NOT use qualitative, GCU leadership does not support a qualitative methodology.

Intervention. You must have an intervention that you implement. Since you cannot evaluate a project that has already been implemented, please write up a description of your intervention and what your role will be in implementing this intervention. This is not a section listed on your 10 Strategic Points document as of yet, so add it after the methodology and design sections. Describe step by step what the intervention consists of, how it is evidence based, how you will implement, and your role in implementation.

Data collection should go step by step (extremely over-detailed) on how you will collect the data. Tell me about all instruments, surveys, and/or questions you will ask of participants. One MUST be a valid and reliable tool.

Data Analysis. Tell me the specific statistics you will use. Start with descriptive statistics, which ones will you use, why (cite current primary sources). Then tell me how you will compare your data (which statistic), what your p value will be before you start your data collection.

Nursing Decision-making

Question 1: How often should the clinician examine the feet of a person with diabetes?

a. Once a year

b. Every 6 months

c. Every 3 months

d. Every visit

Question 2: Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?

a. Cholinesterase inhibitors

b. Anxiolytics

c. Antidepressants

d. Atypical antipsychotics

Question 3: Most adult poisonings are:

a. intentional and self-inflicted.

b. accidental.

c. caused by someone wishing to do harm to the person.

d. not attributed to any reason.

Question 4: A 58-year-old woman presents with a breast mass. Which of the following responses by the clinician would be most appropriate?

a. “It is probably just a cyst, because that is the most common breast mass.”

b. “We will order a mammogram and ultrasound to help establish a diagnosis.”

c. “We will go ahead and schedule you for a biopsy because that is the only way to know for sure.”

d. “Because your lump is painful, it is most likely not cancer.”

Question 5: Which of the following is a specific test for multiple sclerosis (MS)?

a. Magnetic resonance imaging (MRI)

b. Computed tomography (CT) scan

c. A lumbar puncture

d. There is no specific test.

Question 6: After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

a. Suggest she use a heating pad to improve circulation

b. Refer to a podiatrist for a foot care treatment plan

c. Send her for acupuncture treatments

d. All of the above

Question 7: Which characteristic of delirium helps to distinguish delirium from dementia?

a. Abrupt onset

b. Impaired attention

c. Affective changes

d. Delusions

Question 8: Which clinical feature is the first to be affected in increased intracranial pressure (ICP)?

a. Decrease in level of consciousness (LOC)

b. Headache

c. Nausea

d. Widening pulse pressure

Question 9: Jennifer is an 18-year-old girl who comes to the emergency room after a fall during a soccer game. Jennifer explains that she fell on her left side and kept her arm out straight to break her fall. She has been experiencing severe pain and limited range of motion in her left shoulder. The clinician has diagnosed Jennifer with a dislocated shoulder. Which of the following statements are true concerning shoulder dislocation?

a. Posterior dislocations are more common than anterior dislocations.

b. There is a risk of neurovascular and neurosensory trauma, so the clinician should check for distal pulses.

c. Recurrent dislocations are uncommon and would require a greater force to result in injury.

d. Surgery is most commonly the treatment of choice.

Question 10: Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

a. Decreased C-reactive protein

b. Hyperalbuminemia

c. Morning stiffness

d. Weight gain

Question 11: The clinician sees a patient who is 5 feet tall and weighs 150 pounds. How would the clinician classify this patient?

a. Overweight

b. Mild obesity

c. Moderate obesity

d. Morbid obesity

Question 12: The vegetarian patient with gout asks the clinician about food that he should avoid. The clinician should advise the patient to avoid which of the following foods?

a. Rice

b. Carrots

c. Spinach

d. Potatoes

Question 13: A 23-year-old sexually active woman presents for her first Pap smear. Her history includes nulligravida, age at first intercourse 14, and more than 10 sexual partners. Which of the following conditions should the clinician be particularly alert for during her exam?

a. Human papillomavirus (HPV)

b. Endometrial hyperplasia

c. Vagismus

d. Polycystic ovarian syndrome

Question 14: Which of the following classes of drugs should be used as first-line therapy for treatment of delirium?

a. Benzodiazepines

b. Antipsychotics

c. Anticonvulsants

d. Antidepressants

Question 15: What is the treatment of choice for a patient diagnosed with testicular cancer?

a. Radical orchidectomy

b. Lumpectomy

c. Radiation implants

d. All of the above

Question 16: A 24-year-old woman presents to the clinic with dysuria, dyspareunia, and a mucopurulent vaginal discharge. Her boyfriend was recently treated for nongonococcal urethritis. What sexually transmitted disease (STD) has she most probably been exposed to?

a. Gonorrhea

b. Human papillomavirus (HPV)

c. Chlamydia

d. Trichomonas

Question 17: A 58-year-old woman who had a total abdominal hysterectomy at the age of 45 is diagnosed with atrophic vaginitis. Which of the following is the most appropriate treatment?

a. Conjugated estrogen 0.625 mg/day oral

b. Estradiol 7.5 mcg/24 hr vaginal ring

c. Medroxyprogesterone 10 mg/day oral

d. Conjugated estrogen 0.3 mg + medroxyprogesterone 1.5 mg/day oral

Question 18: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

a. Spores

b. Leukocytes

c. Pseudohyphae

d. Epithelial cells

Question 19: Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point?

a. 10%

b. 20%

c. 30%

d. 50%

Question 20: John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain. The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

a. Valgus stress test

b. McMurray circumduction test

c. Lachman test

d. Varus stress test

Question 21: During a digital rectal exam (DRE) on a 75-year-old man, the clinician suspects the patient has prostate cancer. What physical finding should make the clinician suspicious?

a. An enlarged rubbery gland

b. A hard irregular gland

c. A tender gland

d. A boggy gland

Question 22: Janet is a 30-year-old woman who has been recently diagnosed with a herniated disc at the level of L5-S1. She is currently in the emergency room with suspicion of cauda equina compression. Which of the following is a sign or symptom of cauda equina compression?

a. Gastrocnemius weakness

b. A reduced or absent ankle reflex

c. Numbness in the lateral foot

d. Paresthesia of the perineum and buttocks

Question 23: The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (text revision) (DSM-IV-TR) state that excessive worry or apprehension must be present more days than not for at least:

a. 1 month.

b. 3 months.

c. 6 months.

d. 12 months.

Question 24: A patient is diagnosed with hypothyroidism. Which of the following electrocardiogram (ECG) changes should the clinician expect as a manifestation of the disease?

a. Sinus bradycardia

b. Atrial fibrillation

c. Supraventricular tachycardia

d. U waves

Question 25: Which type of burn injury results in destruction of epidermis with most of the dermis, yet the epidermal cells lining hair follicles and sweat glands remain intact?

a. Superficial burns

b. Superficial partial-thickness burns

c. Deep partial-thickness burns

d. Full-thickness burns

Question 26: Immunizations are an example of which type of prevention?

a. Primary

b. Secondary

c. Tertiary

Question 27: If a previously frostbitten area becomes frostbitten again after it has healed, what might occur?

a. Permanent tissue damage may occur, resulting in necrosis to that body part.

b. The area will be super sensitive.

c. The area is prone to a repeat frostbite.

d. The area is as susceptible as any other area.

Question 28: A 26-year-old woman is seen with complaints of irregular vaginal bleeding. Which of the following tests should be the first priority?

a. Pregnancy test

b. Pelvic ultrasound

c. Endometrial biopsy

d. Platelet count

Question 29: Julie, aged 50, has migraine headaches, frequent asthma attacks, coronary artery disease, and hypertension. Which of the following prophylactic medications would you order for her migraines?

a. Propranolol

c. Ergotamine

b. Timolol

d. Topiramate

Question 30: A 64-year-old man with type 2 diabetes presents to the clinic with the complaint of “my feet feel like they are on fire.” He has a loss of vibratory sense, +1 Achilles reflex, and a tack embedded in his left heel. Which of the following would be an appropriate treatment?

a. Tricyclic antidepressants

b. Capsacin cream

c. Vitamin B12 injections

d. Insulin

Assessing Clients (Psychiatric Advance Nursing Practicum)

Learning Objectives Students will: •Assess clients presenting for psychotherapy • Develop genograms for clients presenting for psychotherapy

                                                                                                                                                                              To prepare: • Select a client whom you have observed or counseled at your practicum site. • Review pages 137–142 of the Wheeler text and the Hernandez Family Genogram video in this week’s Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.  

The Assignment

Part 1: Comprehensive Client Family Assessment With this client in mind, address the following in a Comprehensive Client Assessment (without violating HIPAA regulations): •Demographic information •Presenting problem •History or present illness •Past psychiatric history •Medical history • Substance use history •Developmental history •Family psychiatric history •Psychosocial history •History of abuse/trauma •Review of systems •Physical assessment •Mental status exam •Differential diagnosis •Case formulation •Treatment plan

Part 2: Family Genogram Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).

Required Readings:

(1) Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

ATTACHED WITH THIS HOMEWORK IS A SAMPLE OF THIS ASSIGNMENT AND REMEMBER IT HAS TWO PARTS.

Healing And Autonomy Case Study

Write a 1,500 word analysis of “Case Study: Healing and Autonomy.” In light of the readings, be sure to address the following questions:

Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study?

Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?

According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case?

According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James?

Prepare this assignment according to the guidelines found in the APA Style Guide.

NO PLAGIARISM PLEASE, MINIMUM OF 3 REFERENCES

Case Study: Healing And Autonomy

Mike and Joanne are the parents of James and Samuel, identical twins born eight years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’ condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own, or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.

The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.

Two days later the family returned, and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James kidneys had deteriorated such that his dialysis was now not a temporary matter, and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.

James’ nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’ brother Samuel.

Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney, or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? “This time around, it is a matter of life and death, what could require greater faith than that?” Mike reasons.

Write a 1,200-1,500 word analysis of “Case Study: Healing and Autonomy.” In light of the readings, be sure to address the following questions:

Under the Christian narrative and Christian vision, what sorts of issues are most pressing in this case study?

Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James?

According to the Christian narrative and the discussion of the issues of treatment refusal, patient autonomy, and organ donation in the topic readings, how might one analyze this case?

According to the topic readings and lecture, how ought the Christian think about sickness and health? What should Mike as a Christian do? How should he reason about trusting God and treating James?

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Nursing Decision-making

Question 1

A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?

A. A patient whose stage III pressure ulcer required intravenous antibiotics and a vacuum dressing

B. A patient with a history of angina who experienced a non-ST wave myocardial infarction

C. A patient who received treatment for kidney failure due to an overdose of acetaminophen

D. A patient whose pulmonary embolism was treated with a heparin infusion

1 points

Question 2

A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that

A. she will report this to the physician immediately.

B. it may take up to 6 months for the drug to relieve her anxiety.

C. optimum relief of anxiety usually occurs after 3 to 4 weeks of treatment.

D. the drug is not going to work for her and the medication needs to be changed.

1 points

Question 3

A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of

A. diabetic hyperlipidemia.

B. increased intraocular pressure.

C. seizure disorders.

D. low blood pressure.

1 points

Question 4

A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask the patient if she is taking

A. oxycodone (Percodan).

B. secobarbital (Seconal).

C. cimetidine (Zantac).

D. meperidine (Demerol).

1 points

Question 5

A nurse is caring for a patient who has been admitted with acute cocaine intoxication. Which of the following vital signs would the nurse expect to find initially when assessing the patient?

A. BP: 130/88, P: 92, R: 28

B. Blood pressure (BP): 98/50, pulse (P): 120, respirations (R): 40

C. BP: 170/98, P:110, R: 20

D. BP: 150/90, P: 80, R: 16

1 points

Question 6

A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of

A. no nursing action unless the patient experiences a “bad trip.”

B. nonpharmacologic interventions combined with an exercise program.

C. aggressive respiratory assistance

D. drug therapy with bromocriptine (Parlodel).

1 points

Question 7

A patient is suffering from acute inhalant intoxication. The priority nursing intervention will be to

A. assess the patient’s psychosocial status.

B. administer oxygen therapy.

C. provide an emesis basin.

D. administer epinephrine.

1 points

Question 8

A 20-year-old man has begun treatment of the psychotic symptoms of schizophrenia using olanzapine (Zyprexa). Which of the following symptoms would be categorized as a negative symptom of schizophrenia?

A. Visual hallucinations

B. Auditory hallucinations

C. Delusional thinking

D. Lack of interest in normal activities

1 points

Question 9

A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient’s characteristics likely to influence possible treatment with phenytoin?

A. The patient’s heavy alcohol use will compete with phenytoin for binding sites and he will require a higher-than-normal dose.

B. The patient’s protein deficit will likely increase the levels of the free drug in his blood.

C. Phenytoin is contraindicated within 48 hours of alcohol use due to the possibility of paradoxical effects.

D. The patient will require oral phenytoin rather than intravenous administration.

1 points

Question 10

The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be

A. “I’ll ask the nurse practitioner if the dosage can be increased.”

B. “Continue the prescribed dose. It may take several days to work.”

C. “I’ll ask the nurse practitioner if the haloperidol can be discontinued and another drug started.”

D. “I’ll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol.”

1 points

Question 11

A patient who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by

A. inhibiting the action of monoamine oxidase.

B. increasing the effects of the neurotransmitter GABA.

C. increasing the amount of serotonin available in the synapses.

D. affecting the regulation of serotonin and norepinephrine in the brain.

1 points

Question 12

A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan

A. has a shorter half-life than morphine.

B. has less strength in each dose than do individual doses of morphine.

C. causes the respiratory rate to decrease.

D. combined with morphine, increases the physiologic action of the morphine.

1 points

Question 13

A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child’s face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered?

A. Nicotine

B. Cevimeline

C. Atropine

D. Acetylcholine

1 points

Question 14

A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in

A. gastrointestinal distress.

B. cognitive deficits.

C. acute renal failure.

D. liver damage.

1 points

Question 15

A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms?

A. Amphetamines

B. Opioids

C. Benzodiazepines

D. Sedative–hypnotic drugs

1 points

Question 16

A 59-year-old woman has presented to a clinic requesting a prescription for lorazepam (Ativan) in order to treat her recurrent anxiety. Her care provider, however, believes that a selective serotonin reuptake inhibitor (SSRI) would be more appropriate. What advantage do SSRIs have over benzodiazepines in the treatment of anxiety?

A. SSRIs have a more rapid therapeutic effect.

B. SSRIs require administration once per week, versus daily or twice daily with benzodiazepines.

C. SSRIs generally have fewer adverse effects.

D. SSRIs do not require serial blood tests during therapy.

1 points

Question 17

A 64-year-old-patient has been prescribed lorazepam (Ativan) because of increasing periods of anxiety. The nurse should be careful to assess for

A. a history of current or past alcohol use.

B. a diet high in fat.

C. current nicotine use.

D. a diet high in carbohydrates.

1 points

Question 18

Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?

A. Restoration of normal sinus rhythm

B. Resolution of respiratory acidosis

C. Reduction of severe hypertension

D. Increased level of consciousness

1 points

Question 19

A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient’s

A. bowel patterns.

B. urine specific gravity.

C. skin integrity.

D. core body temperature.

1 points

Question 20

A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient’s subsequent care, what nursing diagnosis should the nurse prioritize?

A. Risk for Injury related to drug–drug interactions or drug–nutrient interactions

B. Risk for Constipation related to decreased gastrointestinal peristalsis

C. Risk for Ineffective Peripheral Tissue Perfusion related to cardiovascular effects of phenelzine

D. Risk for Infection related to immunosuppressive effects of phenelzine

1 points

Question 21

A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)?

A. A 20-year-old woman who will take the drug about once a week

B. A 46-year-old man who receives an antidepressant and needs a sleep aid

C. A 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep

D. A 52-year-old woman who needs to fall asleep quickly and stay asleep all night

1 points

Question 22

A 26-year-old professional began using cocaine recreationally several months ago and has begun using the drug on a daily basis over the past few weeks. He has noticed that he now needs to take larger doses of cocaine in order to enjoy the same high that he used to experience when he first used the drug. A nurse should recognize that this pattern exemplifies

A. drug tolerance.

B. dependence.

C. addiction.

D. withdrawal.

1 points

Question 23

A postsurgical patient has been provided with a morphine patient-controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient’s concerns?

A. “It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction.”

B. “You don’t need to worry. It’s actually not true that you can get addicted to the medications we use in a hospital setting.”

C. “It’s important that you accept that your current need to control your pain is more important than fears of becoming addicted.”

D. “If you do become addicted, we’ll make sure to provide you with the support and resources necessary to help you with your recovery.”

1 points

Question 24

A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)

A. The drug does not cause sleepiness in the morning.

B. It is available in both quick-onset and continuous-release oral forms.

C. The drug should not be used for longer than 1 month.

D. It should be taken 1 hour to 90 minutes before going to bed.

E. One of the most common adverse effects of the drug is headache.

1 points

Question 25

A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome?

A. The patient develops yellowed sclerae and intense pruritis (itchiness).

B. The patient demonstrates a significant increase in agitation after being given haloperidol.

C. The patient develops muscle rigidity and a sudden, high fever.

D. The patient complains of intense thirst and produces copious amounts of urine.

1 points

Question 26

A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that

A. there is a risk of systemic absorption of the lidocaine through the patient’s traumatized skin.

B. intravenous lidocaine may be preferable to topical application.

C. lidocaine must be potentiated with another anesthetic in order to achieve pain control.

D. pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site.

1 points

Question 27

Which of the following drugs used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work?

A. Lorazepam (Ativan)

B. Diazepam (Valium)

C. Alprazolam (Xanax)

D. Buspirone (BuSpar)

1 points

Question 28

A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?

A. Liver function studies, pain intensity, and blood glucose level

B. Pain intensity, respiratory rate, and level of consciousness

C. Respiratory rate, seizure activity, and electrolytes

D. Respiratory rate, pain intensity, and mental status

1 points

Question 29

A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to

A. administer after diluting the drug with gabapentin in intravenous solution.

B. inject very slowly, no faster than 100 mg/minute.

C. inject the diazepam very quickly, 15 mg in 10 to15 seconds.

D. avoid the small veins in the dorsum of the hand or the wrist.

1 points

Question 30

A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for

            A.            increased secretions.

B. facial flushing.

C. dizziness

Pathophysiology

D. D. is a 66 year-old female suffering from shortness of breath. She smoked 2 packs a day until she quit 2 years ago. She has a history of bronchiolitis, hyperinflated lungs, pulmonary edema, and syncope. Her primary care practitioner suspects she also has pulmonary hypertension (PH). After examination, D. D. has a PAP of 35 mm Hg and mild CHF.

For this week’s discussion, answer ALL questions below:

  1. What is the prevalence of COPD in the United States? Use the most recent data available and provide a citation for your data.(2 pts)
  2. Do COPD sufferers die of respiratory causes or other causes? Why? (2 pts)
  3. What are the three different medication classes/types of bronchodilators, and how do they EACH function to alleviate the symptoms of COPD? (4 pts)
  4. Is lung transplantation a solution for emphysema patients like D.D.? Why or why not? (2 pts)

Please need done within the next hour, its not paragraph require just questions answered.