1. A nurse assumes a variety of roles while working with clients, which of the following describes the nurses role protecting the client and supporting the clients decisions?

2. A nurse is preparing to administer prescribed medication to a client to demonstrate advocacy, which action should the nurse include in the clients plan of care?

3. A nurse is in the providers office returns a telephone call by the end of the day as promised, to a client who is worried about the outcome of their lab results. Nurse is demonstrating which of the ethical principals?

4. A nurse on the medical surgical unit is assigning task to an AP. Which of the following task to delegate to the AP (select all the apply)

5. A nurse is preparing to administer an enternal feeding via NG, Identify the correct sequence the nurse should follow to initiate the feeding? (move the steps)

6. One of the most commonly used tools in stratigic planning in healthcare organizations in SWOT analyze. What does O mean?

7. A hospital is implementing a new electronic medical records in system. Which factor is the greatest contribution to the resistance encounter with the organizational change?

8. During medication administration a nurse is hit by a client who is confused and uncoorative. The nurse ask the charge if risk restraints can be applied. Apply wrist restraints to a client is an example of which type of tort?

9. A nurse is reviewing a providers prescriptions for four clients, Which is outside the label scope of practice for the nurse.

10. A nurse is reviwing information about the health insurance proberbility and accountability (HIPAA) with newly licensed RN. Which of the following statements by the new RN indicate need further instruction?

Module 04 Project – Ethical Considerations

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Module 04 Content

1.

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A strategic plan is a document used to structure and communicate organizational goals. It is also used to mitigate risks and alleviate the potential for legal cases. Barbara receives information that there is an additional, more pressing issue at a satellite clinic that is not documented in the original UCCO case. This issue relates to the emergency care clinic, which is used to treat patients with trauma-related injuries. The clinic has been over-utilized for the past year, resulting in stressed staffing, overwhelming costs, and decreasing quality of patient care and customer satisfaction. Staff productivity is affected by use of personal cell phones and clinic equipment is often used for social media.

In one particular case, a 13-year old patient was seen for trauma care by the UCCO Emergency Clinic. The patient’s parents make it clear to the staff that they are not willing to give consent to any procedure involving blood products or transfusion. The risks are explained to the parents. The patient arrived unconscious but shortly regains consciousness. After the parents leave the room, the patient tells the nurse that she is afraid of dying and would like any care, including blood procedures and products, to save her life. The nurse later finds out that the rejection by the parents was due to religious reasons. The nurse quickly discusses the case with fellow employees, one of which posts comments on her social media page using a clinic-owned computer. The nursing director give a verbal warning to all involved nurses and staff.

Visit the Rasmussen online Library and search for a minimum of 3 articles covering the topics of ethics, healthcare professionalism, and federal legislations. Conduct academic research using the library’s databases, like:

· CINAHL

· Discovery

· Business Source Complete via EBSCO

· Business via ProQuest

In the databases use basic search languages (controlled vocabulary/keywords) to determine ethics laws specific to this situation. Some keywords to consider are healthcare professional code of ethics. Then, refine your searches based on your search results. Make sure to include a minimum of 3 credible, academic sources in your paper.

Using your research, address the following points in a minimum of 3-page report:

· Was the nursing manager legally compliant with to protect patient information? Explain the legal risks and support with federal legislations and professional expectations, such as HIPAA and professional codes of ethics.

· What bearing does the age and religious requests have on the patient’s case? Are there medical and ethical laws that supersede the parent’s requests?

· What is the role and importance of communication among UCCO facilities, particularly in reference to compliance and ethical standards?

· What are the ethical and professional factors of using social media?

· Were the reactions to the patient’s case illegal, or just unethical? How does this align with UCCO’s mission, values, and strategic action plans? How does it compare to your own personal beliefs and values?

Remember to integrate citations accurately and appropriately for all resource types; use attribution (credit) as a method to avoid plagiarism. Use NoodleBib to document your sources and to complete your APA formatted reference page and in-text citations.

Transferable Skills for this Project Stage:

· Ethics & Professional Responsibility

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Consider that a 7-year-old pediatric patient, who is severely affected by autism spectrum disorder, has been admitted to the hospital with an infection. Utilizing current research and the DSM-V. identify and describe at least 15 possible behaviors. attributes, and developmental delays exhibited by the child. Based on this information, identify and describe at least 10 potential safety concerns for the hospitalized child with severe autism.

For each of the identified safety concerns. create and describe at least 1 nursing intervention to reduce the risk of injury to the child. Compare and contrast the hospital safety concerns/interventions for a typically developing 7-year-old child with those of a child affected by severe autism. (Human Development, Safety)

There are an abundance of hormone therapies that are aimed at replacing hormones due to the natural process of menopause, cancer and more recently feminizing hormone therapy (Unger, 2016). Here we will discuss estrogen therapy and its role in the treatment of menopause. There are a number of associated symptoms with menopause including the typical vasomotor symptoms (hot flashes, night sweats and flushing), sleep disturbances, atrophic vaginitis, fatigue, and decreased libido (Valdes, 2022). Due to these symptoms and more, quality of life can be severely diminished. Menopause is also associated with the alkalinization of the vaginal canal, raising the PH to 6.5-7 which is correlated with increased risk of UTI’s and cervical tumors (Valdes, 2022). Treatment depends on symptoms to be treated. Systemic treatment is warranted for the vasomotor symptoms such as hot flashes while local treatment is for symptoms specifically involving the uterus or vagina (Valdes, 2022). Side effects include nausea, bloating, headaches, breast tenderness and leg cramping. Risks include breakthrough vaginal bleeding and an elevated risk for breast or endometrial cancer (Valdes, 2022) which is why estrogen therapy is not recommended for long term therapy.

Unger C. A. (2016). Hormone therapy for transgender patients.  Translational andrology and urology,  5(6), 877–884.  https://doi.org/10.21037/tau.2016.09.04

Links to an external site.

Valdes A. & Bajaj T. (2022) Estrogen Therapy.  StatPearls [internet]. Treasure island (FL): StatPearls Publishing. Available from:  https://www.ncbi.nlm.nih.gov/books/NBK541051/

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According to Adams et al. (2017), low doses of estrogens and progestins prevent conception by blocking ovulation, and estrogen–progestin combinations are used for hormone replacement therapy during and after menopause. The authors state that the long use of these combinations has serious adverse effects. Estrogen is a general term that includes three different hormones which are estriol, estrone, and estradiol. Both estrogen and progesterone are used for several therapeutic goals. They are used to prevent pregnancy and treat symptoms of menopause (Adams et al., 2017).

In addition, Adams et al. (2017) state that therapy with hormonal contraceptives increases the risk of cardiovascular adverse effects such as hypertension and thromboembolic disorders. The estrogen part of the pill can lead to venous and arterial thrombosis which may lead to pulmonary embolism or a stroke. In addition, it may cause uterine bleeding, elevated plasma glucose, and retinal disorders (Adams et al., 2017).

According to Adams et al. (2017), menopause occurs due to a decrease in estrogen secretion by the ovaries. It is often managed with hormone replacement therapy. This therapy includes estrogen, sometimes combined with progestin. Women who use estrogen-progestin combination therapy have a high risk of stroke, breast cancer, dementia, venous thromboembolism, and myocardial Infarction. However, they have a lower risk of hip fractures and colorectal cancer. In addition, women who only take estrogen do not have an increased risk of breast cancer or myocardial Infarction, but they do have an increased risk of stroke and thromboembolic disorders. Women who take estrogen should be educated about adverse effects that include edema, breast tenderness, abdominal cramps, acute pancreatitis, appetite changes, acne, mental depression, headache, fatigue, nervousness, weight gain, and nausea (Adams et al., 2017).

According to Kim et al. (2021), hormone therapy reduced the risk of Alzheimer’s and neurodegenerative disease, especially in women who are 65 years old or older. The authors also state that diseases such as Parkinson’s disease, multiple sclerosis, dementia, and amyotrophic lateral sclerosis are reduced with the use of oral hormone therapy (Kim et al., 2021).

According to Shifren et al. (2019), hormone therapy is the most effective treatment for managing menopausal symptoms, such as hot flashes and night sweats. The authors also state that hormone therapy is beneficial for bone mineral density, urogenital tract, and even reducing the risk of fractures. In addition, low doses of estrogen can be applied in the vaginal area to improve sexual quality of life. Transdermal estrogen therapy has more benefits than oral therapy, especially for women who are obese or have many risk factors for developing cardiovascular diseases. Moreover, all estrogen patches have estradiol which is a natural hormone that is produced by the ovaries during the reproductive years (Shifren et al., 2019).

In addition, according to Shifren et al. (2019), there is no significant increase in the risk of heart disease in women who get estrogen or estrogen-progestogen therapy who were younger than 60 years or within 10 years since the time menopause started. The authors also state that although venous thrombotic complications increase with oral estrogen, there is no increased risk with the use of transdermal estradiol. In addition, there is a slight increase in the risk of breast cancer with estrogen-progestogen therapy, but only after using it for about four years. Moreover, there is no increased risk of developing breast cancer with short-term use of estrogen-progestogen therapy or in women who use only estrogen (Shifren et al., 2019).

Shifren et al. (2019), state that oral estrogen use increases the risk of gallbladder diseases but it does not happen with the use of transdermal estradiol. Overall, starting hormone therapy in women older than 60 years or more than ten years after the beginning of menopause has an increased risk of complications (Shifren et al., 2019).

References

Adams, M. P., Holland, N., & Urban, C. Q. (2017). Pharmacology for nurses. A pathophysiologic approach.  (5th ed.). Pearson Education.                                                 https://online.vitalsource.com/books/9780134255378

Kim, Y. J., Soto, M., Branigan, G. L., Rodgers, K., & Brinton, R. D. (2021). Association between menopausal hormone therapy and risk of                                            neurodegenerative diseases: implications for precision hormone therapy. Alzheimer’s & Dementia: Translational Research & Clinical                                           Interventions, 7(1). https://doi.org/10.1002/trc2.12174

Shifren, J. L., Crandall, C. J., & Manson, J. A. E. (2019). Menopausal hormone therapy. The Journal of the American Medical Association, 321(24), 2458–                   2459. https://doi.org/10.1001/jama.2019.5346

Sinusitis and bronchitis are inflammatory processes due to infections. Often, they are related to viral illnesses and antibiotics are not warranted. This is true of bronchitis and sinusitis treatment. In a study review, Smith et al, (2017) found no statistical significance in using antimicrobial therapy with bronchitis and cough. They did find they find that there may be some small benefit in some populations such as geriatrics with multiple comorbidities. Although often I see Z-Packs prescribed for these ailments, the risk of increasing resistance of pathogens occurs when antibiotics are over prescribed for what are often viral illnesses (Smith et al, 2017). In cases of pharyngitis, use of antibiotics is warranted if cultures are positive for strep. In this case, penicillin related treatments are widely used such as amoxicillin (Nakao et al, 2019). This has a gross impact on practice implications due to the threat of creating antimicrobial resistant organisms. Clinicians need to be certain of what they are treating and prescribe accordingly. Although I’ve seen some clinicians prescribe antibiotics to patients with likely viral symptoms just to keep the patient happy to keep their HCAP scores up. But that’s an argument for another day entirely.

Nakao, A., Hisata, K., Fujimori, M., Matsunaga, N., Komatsu, M., & Shimizu, T. (2019). Amoxicillin effect on bacterial load in group A streptococcal pharyngitis: comparison of single and multiple daily dosage regimens. BMC pediatrics, 19(1), 205. https://doi.org/10.1186/s12887-019-1582-8

Smith, S. M., Fahey, T., Smucny, J., & Becker, L. A. (2017). Antibiotics for acute bronchitis. The Cochrane database of systematic reviews, 6(6), CD000245. https://doi.org/10.1002/14651858.CD000245.pub4

Bronchitis refers to the inflammation of the bronchial tubes, the airways that carry air to one’s lungs. Symptoms of bronchitis include fatigue, chest discomfort, sinus congestion and bad breath. In order to treat bronchitis, many antibiotics are used such as Amoxicillin, Deoxycycline, Erythromycin, Azithromycin, and Cefuroxime (Smith et. al., 2014). Often times, if bronchitis is caused by a viral infection, antibiotics are rendered useless. Bronchitis leads to more inappropriate antibiotic prescriptions in adults (Harris et. al., 2016). When a patient is taking an antibiotic for a diagnosis that may not call for antibiotics, they are increasing the prevalence of antibiotic resistant bacteria. Appropriate antibiotic prescribing is critical as it results in fewer adverse effects in patients.

References Harris, A. M., Hicks, L. A., & Qaseem, A. (2016). Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults: Advice for High-Value Care From the American College of Physicians and the Centers for Disease Control and Prevention. Annals of Internal Medicine, 164(6), 425. https://doi.org/10.7326/m15-1840

Links to an external site.

Smith SM, Smucny J, Fahey T. Antibiotics for Acute Bronchitis. JAMA. 2014;312(24):2678–2679. doi:10.1001/jama.2014.12839