Nursing Care For Aboriginal Client

Mr. Joe Munsie, an 80 year old aboriginal male client, was admitted to the hospital on 7/03/11 with Chronic Airways Limitation (CAL), Diabetes and the associated complications of Hypertension, Congestive Cardiac Failure (CCF) with acute exacerbation. His medical history includes coronary artery disease for the past 12 years. He had a balloon angioplasty in 2000 and a Myocardial infarction (M.I.) in 1988. His other symptoms include shortness of breath (SOB), kidney disease, impotence, peripheral neuropathy, glaucoma and repeated infections due to his poor immunity. He has had trouble passing urine at times and has had nocturia six times in the past week. He is a widower, states that for the past 3 to 4 weeks he has had increasing fatigue and shortness of breath. He visited his doctor two days ago, and his medications were changed. His preferred foods are fresh fruits and boiled vegetables. Mr. Munsie lives with one of his daughters and her family since experiencing his M.I.in 1988. He has six other children. He is a Catholic and attends church intermittently, however, since his declining health, he has been confined to his home. He smoked three packs per day x 40 years and quit in 1990. He currently sleeps on 4 pillows at night to ease breathing. He is hearing impaired and wears bilateral hearing aids. He wears glasses and reads with some difficulty. His schooling was to a Year 9 level of high school. He also has a previous history of heavy alcohol consumption for a number of years but very little now consumed. Nursing Care For Aboriginal Client

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Admitting history:

This is his third admission for CCF since his diagnosis five years ago. Physician progress notes state: Condition improving; complaining of (c/o) increasing SOB; chest x- ray improving; serum K+ is 2.9 mmol/L, with a weight gain of 5kg in the past two months. Poor diabetic control. He has moderate respiratory distress on exertion and crackles auscultated in left lung base. Nursing Care For Aboriginal Client

Physical exam                       Vital Signs:     T = 37.4 oC, BP = 178/95 mm/hg, P = 110 bpm,

Ht = 176cm, Wt =120Kg, BGL = 12mmol/dl, O 2 SAT level = 90% on room air Bilateral swollen ankles evident with pitting oedema at 2+. Pedal pulses present. Complaining of increasing fatigue and severe shortness of breath (SOB) and leg pain on walking. Denies chest pain.

Medications ordered

Digoxin 0.25 mg po daily

Lasix 40 mg po bd

Nitro Patch 25 mg Top On at 0800 and Off at 2000

Metamucil 15 ml po daily in glass of water/juice

Slow K 600mg po daily

Lantus 80 units daily

Novo rapid 25 unit’s qid

Timoptol 2 (guttae) drops daily

Diagnostic tests results

7/3/2011-Chest X Ray     Mild left ventricular hypertrophy and pulmonary congestion resolving.

7/3/2011
Serum electrolytes:			Normal Ranges:
Na+	138 mmol/L		135-145	mmol/L
K+	2.9 mmol/L		3.8 – 4.9	mmol/L
Ca+	2.1 mmol/L		2.10 – 2.55 mmol/L
CL	102 mmol/L		95 – 110   mmol/L
Urea	8.6 mmol/L		3.0 – 8.0   mmol/L
Cr	0.6 mg/dl		0.8 – 1.4	mg/dl
Serum albumin 28 g/L			35 – 47	g/L
Serum digoxin level 2.6 ng/dl			0.6 – 2.3	nmol/L
Full Blood Count:
Hb		100 g/L	130 – 180	g/L
WCC		12 x 109/L	4.0 – 11.0 x 109/L
Platelets		125 x 109/L	150 – 400 x 109/L
HbA1C		10 %	4.0 – 5.5 %

Other admitting orders

Diabetic/No added salt diet; Restricted fluids 1,200 ml/day, Monitor input & output, daily weight, activity as tolerated, Monitor bowel actions, 4^th hourly observations, O ₂ at 3L/min per nasal cannula.

Nursing Interview & Observations

He states, ‘I have a touch of the sugar and my old heart is just wearing out. I get this extra fluid every now and then. I come here to the hospital to get rid of it’. He is well oriented, however, he is a poor historian with limited understanding of medications and treatments utilized at home. He complains of frequent constipation. Skin reddened over bony prominences and has small shallow ulcers on both his shins that are inflamed and weeping. Currently requires the head of his bed elevated to assist with his breathing. Requires lift up walking frame when ambulating as he has an unsteady gait. He requires assistance with most activities of daily living. Nursing Care For Aboriginal Client

Questions

Question 1: Identify and briefly describe three (3) of Mr Munsie’s medical conditions.

Question 2: Explain how each of the above identified medical conditions result in pathophysiological changes that impact on each body system. Also their related structures e.g. Persons with diabetes, which is a disease of the endocrine system, who have poor glycaemia control, may have resultant damage to microvascular structures leading to blindness or damage of macrovascular structures resulting in peripheral gangrene.

Question 3: Describe briefly how two (2) Medical and two (2) Pharmacological interventions act to enhance Mr Munsie’s wellbeing. E.g. Mr Munsie has Congestive cardiac failure which has led to peripheral oedema and shortness of breath. He has been placed on a diuretic medication to assist his body to excrete excessive fluid.

Question 4: Review Mr Munsie’s Physical examination, and the Diagnostic Test Results. Identify and describe briefly four (4) abnormal parameters.

Question 5: Identify the drug actions, indications and contra indications for the following medications. Digoxin, Lasix, Slow K, Nitro patch and Timoptol.

Question 6: List four 4 diagnostic investigations that could assist in the diagnosis and management of Mr Munsie’s medical conditions.

Question 7: Identify and provide a brief rationale for four (4) services that meet the psychosocial and or medical needs of Mr Munsie on discharge.  Nursing Care For Aboriginal Client

 

Treatment And Diagnosis Of Child with drug abuse

Hongbiao Liu’s career path has been to be a doctor. His family members may have possibly influenced his career path. Beginning with his parents, all the members of his family have keenly followed in their footsteps. Living in an environment full of doctors is the reason Liu developed an interest in matters related to being a doctor. Subsequently, it is this interest that got him to join the medical school and pursues medicine until he acquired his PhD.

Dr. Liu has specialized in internal medicine as well as nuclear medicine in buffalo. He dedicated two of his years in studying internal medicine, which he studied in Florida. For three years, Liu studies nuclear medicine in Buffalo, which was followed by Nuclear-Radiology fellowship that he studied in Cleveland for one year. Following his intensive learning, Dr. Liu has worked for several reputable institutions such as the Memorial Medical Center and Brylin Hospital, which have helped him gain more knowledge Treatment And Diagnosis Of Child with drug abuse.

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The medical field has changed tremendously since Dr. Liu finished Med school in 1981. Ever since, he has been practicing in the medical field and has seen numerous changes take place, such as the introduction of computers, modern medicine, as well as treatment for the diagnosis. When Dr. Liu started serving in the medical field, the use of computers was minimal within the field. However, hospitals have increased the use of computers, which are used to store a majority of the hospital’s information, including that of the patients they serve daily. Additionally, the medical field has been on the frontline of adopting the use of technology. Subsequently, the use of technology has resulted in better treatment as well as diagnosis.

The most memorable patient experience for Dr. Liu was when he diagnosed a small child with drug abuse and more specifically, cocaine. To him, this was a shocking incidence because he knew the effects of cocaine. Furthermore, the surprising part to him and the unanswered question was how a child as young as his patient had gained access to such an expensive and addictive drug Treatment And Diagnosis Of Child with drug abuse.

For Dr. Liu, the current treatment for cancer was not as proper as people thought. He suggested that there was still room for improvement, especially considering the technological developments in the medical field. Liu argued that if more research was done, better methods of treatment for cancer would be identified, which would consequently help in mitigating the disease.

According to Dr. Liu, communication is vital for any medical practitioner. Any physician treating cancer should possess the communication skill since it is through communicating that the patient can feel comfortable. When a patient is comfortable, he or she will give detailed information concerning how he or she feels. Liu alluded that being a physician is not about dealing with medicine, but instead being a physician is an art, and thus, a physician is an artist.

Dr. Liu’s typical work week is busy, and therefore, his biggest challenge is time. According to him, he lacks time to perform even the most essential things, such as eating. His day is usually hectic due to a lot of workloads. Subsequently, his busy schedule can be witnessed by the way this interview was conducted since it was conducted as he was going for lunch, due to his lack of time Treatment And Diagnosis Of Child with drug abuse.

The cure for cancer can only be acquired in future if there will be cooperation in every aspect. This cooperation should be between all sectors starting with the government having a partnership with the researchers in the medical field. The development of a collaboration between different institutions will bring funds as well as knowledge together, which can be used to develop radiotherapy to an advanced level so that a cure is acquired.

If given a billion dollars, Dr. Liu would fund the research of cancer in every aspect so that the various strategies in place could be combined to come up with a concrete solution for the development of the cure for cancer. The research can be conducted from multiple points of view. Each point of view will have a separate observation and conclusion. Combining these conclusions would result in the development of an outcome, which could be a cure for cancer.

When asked what it takes to be a better physician, Dr. Liu said that the essential thing is to become an artist in the medical field. Moreover, he added that communication is critical in any field. When dealing with patients, it is vital to be friendly because it creates a conducive environment for the patient. Through communication, the physician and the patient will interact, which will result in quality treatment Treatment And Diagnosis Of Child with drug abuse.

Ethical Issues Discussion Essay

It has become necessary to ration a vaccine for a contagious disease. There is only enough vaccine available to cover 25% of the U.S. population. It is now crucial to determine an appropriate method to ensure coverage for 100% of the U.S. population, but how?

Instructions:

1. Re-read the statement above and reflect on a possible solution.
2. Examine the following theories below:
   1. Utilitarianism
   2. Rights-based
   3. Duty-based
   4. Justice-based
   5. Virtue-based
3. Please answer the following question:
   • Is there any combination of the above theories or another theory that would guide you to a more ethical solution for distribution and the right order of distribution?
4. Answer the questions as thoroughly and concisely as possible.
   • Be sure to reference any works that you utilize in answering the questions (Be sure that references are in APA format).It has become necessary to ration a vaccine for a contagious disease. There is only enough vaccine available to cover 25% of the U.S. population. It is now crucial to determine an appropriate method to ensure coverage for 100% of the U.S. population, but how?
     

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     •  

       Instructions:

       1. Re-read the statement above and reflect on a possible solution. Ethical Issues Discussion Essay
       2. Examine the following theories below:
          1. Utilitarianism
          2. Rights-based
          3. Duty-based
          4. Justice-based
          5. Virtue-based
       3. Please answer the following question:
          • Is there any combination of the above theories or another theory that would guide you to a more ethical solution for distribution and the right order of distribution?
       4. Answer the questions as thoroughly and concisely as possible.
          • Be sure to reference any works that you utilize in answering the questions (Be sure that references are in APA format).It has become necessary to ration a vaccine for a contagious disease. There is only enough vaccine available to cover 25% of the U.S. population. It is now crucial to determine an appropriate method to ensure coverage for 100% of the U.S. population, but how?

            Instructions:

            1. Re-read the statement above and reflect on a possible solution.
            2. Examine the following theories below:
               1. Utilitarianism
               2. Rights-based
               3. Duty-based
               4. Justice-based
               5. Virtue-based
            3. Please answer the following question:
               • Is there any combination of the above theories or another theory that would guide you to a more ethical solution for distribution and the right order of distribution?
            4. Answer the questions as thoroughly and concisely as possible.
               • Be sure to reference any works that you utilize in answering the questions (Be sure that references are in APA format). Ethical Issues Discussion Essay

Ethics for Nurses Assignment

Nurses should not participate in active euthanasia since it involved the termination of a person’s life, which is unethical since they do not have the right to determine if they live or die. This is no way to accurately determine if a person will not recover from the ailments; thus, choosing to authorize a person makes the morality of a nurse questionable. Active euthanasia is a controversial topic that contradicts the nurse’s duties, and when a nurse engages in the practice, they disregard their duty to care for the patient. The choice for euthanasia is made in moments of desperation, which means that the patient and their family are not likely to make an informed decision.

According to the Code of Ethics for Nurses with Interpretive Statements, the American Nursing Association (ANA) deems the act a violation of the code for nurses since it goes against the code of ethics, traditions, and professional goals. The code of ethics promises to promote a patient’s health, which is geared toward saving a life, making termination against the code (provision 5.2). Participation in active euthanasia makes the nurse an active participant in the death of the patient. The nurse will have to administer an agent that kills the patient painlessly, which is irreversible if the participants have a change of mind after initiating. A nurse should not participate in any activity that harms their patient or, in this case, terminates their life. Ethics for Nurses Assignment

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Nurses should not be required to receive the COVID vaccination since it should be a person’s choice to make individually. Moreover, the requirement could deny the public the care they deserve since the move could make many professionals seek other opportunities that do not place such requirements. Any medication should be a personal choice; thus, it should be optional to take the vaccine. The COVID vaccine is a new development. Many people in the society are skeptical about it, and making it mandatory for people, places the responsibility on the ANA and the government. Additionally, requiring a nurse to be vaccinated violates the nurse’s freedom of choice and makes the process difficult. Even those who are willing to vaccinate will resist because the option has been eliminated.

The Code of Ethics for Nurses with Interpretive Statements indicates that requiring a nurse to receive a COVID vaccination is unethical since it goes against their right to make an informed choice. This means that nurses should be allowed to decide when to take the vaccination and which one they will take based on the factors they will consider (provision 4.3). Nurses cannot advocate for a treatment that they do not trust, and forcing them to get vaccinated does not help and might cause a negative attitude to the medications and slowdown herd vaccination. The code of ethics is set as a guideline, and it should be applied despite the circumstance since consistency in the care facility ensures reliability and trust in the system.

A person would advise the graduate nurse not to get involved in the incident since it could be used against them if she does not have evidence for the occurrence. Since it is the graduate’s first day, she makes a good impression, which means that she does not create differences with her colleagues. However, if there is an anonymous way to report the case, the nurse should take advantage of it to foster responsibility in the care facility. A nurse has a duty to self and others. Since the graduate has witnessed the patient’s dignity being violated, they must ensure that they rectify the situation and receives good health care despite their challenges.

The Code of Ethics for Nurses with Interpretive Statements dictated that nurses should respect human dignity; thus, by admonishing the patient, the nurse practice unethical behavior. The graduate nurse is expected to protect the patients’ rights, which means that the code of ethics expects her to report the situation so that corrective action can be taken to ensure it does not occur in the future (provision 1.1). Reporting the unethical activity will ensure that the nurse maintains integrity which will be helpful thorough the career development. Ethical behavior ensures that a patient is not mistreated in the hospital, which the nurse has done to the incontinent patient. Reporting the nurse will create a good culture in the care facility where all staff members conduct themselves professionally to ensure they are within practice guidelines.

Discussing a patient in a public area with another nurse is inappropriate since it could leak the patient’s health information. Suppose an unauthorized person overhears the information and uses it maliciously, the patient’s right to privacy would have been breached. The nurses should not engage in such behavior in respect of their professionalism. Ethics for Nurses Assignment  Discussion should be done with, authorized personnel and in the required environments to preserve the confidentiality promise promised to the patient. The collaboration of staff is encouraged, but the discussions’ setting makes the patients personal health information exposed, which could violate their rights.

According to the Code of Ethics for Nurses with Interpretive Statements, nurses are charged with protecting and promoting the rights of the patients they serve. This means the nurses should not have discussed the patient information in the cafeteria to protect their confidentiality (provision 3.1). Professionalism dictates that the nurses should have chosen a better environment to do the discussions. If another patient heard the discussions, they would not trust the institution to provide confidentiality with their health conditions which can affect the reputation of the care facility. Nurses are held to the expectations to uphold the code of ethics than the nurses in the cafeteria fail to meet the standards, which means they should reevaluate their conduct and refrain from such incidents in the future. Ethics for Nurses Assignment

There should be mandated continuing education requirements before renewing a practice license to ensure the nurse’s care methods are updated.  Continuous education is necessary because the nursing profession is dynamic and requires a professional to be continuously updated. Continuous education also allows nurses to venture into new skills to improve their profession. Continuing education should be presented before a license renewal as proof of a nurse’s competence since they are dealing with the health of human beings, which is a sensitive profession.

The Code of Ethics for Nurses with Interpretive Statements indicates that the profession’s integrity requires nurses to continually improve their profession to ensure they are competent in modern care provision. The codes also place this as a condition for licensing to ensure that the level of care provided in the country is in peak condition (provision 3.4). Before renewing a license, continuing education ensures that the nurse can be more efficient due to progressive treatment measures and equipment. The knowledge could save a person’s life, and lack thereof could cost them.

 References

Bell, L. (2015). Code of ethics for nurses with interpretive statements. Critical Care Nurse, 35 (4), 84-84. Ethics for Nurses Assignment