2023 This patient is most likely to have plaque psoriasis the most common form

Nursing 2023 reply to cathy need 2 current apa citations

This patient is most likely to have plaque psoriasis the most common form 2023 Assignment

 

This patient is most likely to have plaque psoriasis, the most common form of psoriasis in young adults, with the average age of onset in the early twenties (Dunphy, Winland-Brown, Porter, & Thomas, 2015).)

            The risk factors for the development of psoriasis are family history. One-third of all patients with psoriasis have a relative with the disease, as in the case study above. When a parent is affected the children have a tendency for an early onset of the condition. Not only that but when both parents are affected the chance increases to forty-one percent of the children having the condition. This patient had an upper respiratory infection prior to the outbreak of the rash; this predisposes her for an outbreak of psoriasis. Even though there is a genetic disposition of the offspring of the parents having the disease, the exact genetic cause is unknown. Research is ongoing regarding the genetic and environmental influences on the cellular effects of the disease (Dunphy, Winland-Brown, Porter, & Thomas, 2015).

          The diagnostic tests to order for this patient are a CBC with differential and serum chemistry profile, serum uric acid level, antinuclear antibody titer, and rheumatoid factor. The serum uric acid level may be elevated. Diagnostic procedures are the Psoriasis Area and Severity Index, which evaluates overall severity and BSA involvement, and the Dermatology Life Quality Index. The top three differentials are seborrheic dermatitis, nummular eczema, and atopic dermatitis (Dominic, Bolder, & Golding, 2019)

            The goal of treatment for the condition of Psoriasis is to identify and avoid triggers. If the condition is mild to moderate keeping the skin hydrated with petrolatum ointments is helpful. Topical corticosteroids are also helpful initially in treating the disease and preventing skin atrophy. In the adult, initial therapy should be corticosteroids with varying potencies. These treatments should not be used longer than 4 weeks (Hendriks… et al, 2013).

            Follow-ups should be done to measure the body surface area involvement and to see if the therapy is working. If the therapy is not working alternative treatments should be prescribed or the addition of another agent to treat the condition should be done. If the psoriasis is greater than twenty percent of the body surface area, or severe extremity involvement especially of the hands and feet develops, a referral is needed (Menter, Gottlieb, Feldman, Van Voorhees, Leonardi, Gordon, et al…2008).

References

Domino, F., Baldor, R. A., & Golding, J. (2019). The 5-minute clinical consult. (27th

Ed.). [Mobile application software.] Retrieved from http://itunes.apple.com

Dunphy, L.M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary

care: the art and science of advanced practice nursing. (4th Ed.). Philadelphia, PA. F. A. Davis Company.

Hendriks, A. G., Keijsers, R. R., de Jong, e. M., Seyger, M. M., van de Kerkof, P. C.

(2013). Efficacy and safety of combinations of first-line topical treatments in chronic plaque psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 27(8) 931-951. doi:10.1111/jdv.12058

Menter A, Gottlieb A, Feldman SR, Van Voorhees AS, Leonardi CL, Gordon KB,et al.

(2008). Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 58(5):826-50. 

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2023 Tutor MUST have a good command of the English language These are two discussion questions Your DQ1 and DQ2 posts

Nursing 2023 Discussion questions

Tutor MUST have a good command of the English language These are two discussion questions Your DQ1 and DQ2 posts 2023 Assignment

Tutor MUST have a good command of the English language

These are two discussion questions

Your DQ1 and DQ2 posts must be at least 150 words each and have at least one reference cited for each question. In-text citation, please

DQ 1

Discuss how genetic and genomics can play a role in a demand for new health services and how it may impact health care expenditures in the aging population. Give one example

DQ 2

Describe one method that includes using evidence-based data to support a new or innovative ways to care for the aging now or in the future. How will it impact care and what are the anticipated outcomes? 

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2023 Chapter 50 The diabetic educator for a local hospital has been asked to

Nursing 2023 Diabetes Mellitus

Chapter 50 The diabetic educator for a local hospital has been asked to 2023 Assignment

 

Chapter 50

The diabetic educator for a local hospital has been asked to teach a group of adult patients newly diagnosed with type 1 and type 2 diabetes on “how to effectively manage diabetes.”

a.            What would be a useful approach to this request?

b.            How would you explain to this group of patients the potential complications of diabetes and the impact of those on their lives?

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2023 Prepare this assignment as a 1 500 1 750 word paper using the instructor feedback from the previous course assignments and the

Nursing 2023 Revise The PICOT Question You Wrote In The Topic 1 Assignment Using The Feedback You Received From Your Instructor.

Prepare this assignment as a 1 500 1 750 word paper using the instructor feedback from the previous course assignments and the 2023 Assignment

 

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

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

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2023 1 minimum 5 full pages not words cover or reference page not included 2 APA norms All

Nursing 2023 Critique a Research Article – Nursing Research

1 minimum 5 full pages not words cover or reference page not included 2 APA norms All 2023 Assignment

 

1) **********minimum 5 full pages ( not words)**************************** (cover or reference page not included) 

2)¨**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format and each paragraph must have at least 4 sentences)

3)********** It will be verified by Turnitin and SafeAssign 

4) **********References from the last 5 years 

Mandatory: See the rubic. based on this information changes will be requested or work delivery will be accepted

_________________________________________________

Instructions:

  

Title page: Give the name of the article, the authors name(s) and your name. Following APA

*****Introduction:

· Provide an overview of the author’s research problem, research questions and main point including how the author supports his or her point. 

· Explain what the author initial  objectives (hypothesis) and results including the process he or she used to arrive at such conclusion. 

Evaluate the Research Methods: in paragraph form answer the following:

· Does the author provide a literature review? 

· Is the research current and relevant to today existing health issues?

· Describe the research type utilized?– experimental, non-experimental, quasi experimental, etc. 

· Evaluate the sample (size, composition, or in the way the sample was selected in relation to the purpose of the study? Was the sample appropriate for the research or was it bias? 

·  How practical does this work seem to you? How does the author suggest research results could be applied and how do you believe they could be applied? 

·  Could the study have been improved in your opinion? If so provide how you think it could have improved. 

·  Is the writing in the article clear straightforward?

·  Can further research be conducted on this subject? Explain

Conclusion: In your conclusion, try to synthesize the pieces of your critique to emphasize your own main points about the author’s work, relating the researcher’s work to your own knowledge or to topics being discussed in your course 

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2023 1 Provide three differential diagnoses based on Janet s subjective and objective data

Nursing 2023 PATHO WEEK 3 DISCUSSION

1 Provide three differential diagnoses based on Janet s subjective and objective data 2023 Assignment

1. Provide three differential diagnoses based on Janet’s subjective and objective data and discuss your reasoning for each.

Hay fever, food allergies and viral infection that presents as a cold with allergic symptoms would be the top three indications based off of the signs and symptoms being presented by Janet (Mayo Clinic, 2019b). Hay fever causes seasonal allergies along with a clear runny nose, post-nasal drip and irritated nares. Food allergies can cause eczema and allergic symptoms affecting the ear note and throat (Mayo Clinic, 2017). A viral infection such as the common cold can also exacerbate a runny nose, sneezing, post-nasal drainage and inflamed lymph nodes (Mayo Clinic, 2019a).

2. What additional history questions would be useful in your evaluation of Janet?

You can ask valid questions such like when did the symptoms begin? Have you been around anyone else who is sick? What makes the symptoms worse? Have you had a recent in change in environment or food? What makes the symptoms seem worse or better? Have you tried taking any medication and if so, what has worked/not worked? Does anyone in your family suffer from any allergies? Have you had seasonal/food allergies ever checked? 

3. Discuss the pathophysiological process of your primary diagnosis.

Janet is suffering from Hay fever during the changes in seasons during Spring and Fall which is when pollen counts are elevated. According to Mayo Clinic (2019) Hay fever, also called allergic rhinitis, causes cold-like signs and symptoms, such as a runny nose, itchy eyes, congestion, sneezing and sinus pressure. But unlike a cold, hay fever isn’t caused by a virus. Hay fever is caused by an allergic response to outdoor or indoor allergens, such as pollen, dust mites, or tiny flecks of skin and saliva shed by cats, dogs, and other animals with fur or feathers (pet dander).

4. Differentiate the types of hypersensitivity mechanisms.

Type I hypersensitivity is also known as immediate or anaphylactic hypersensitivity. The reaction may involve skin (urticaria and eczema), eyes (conjunctivitis), nasopharynx (rhinorrhoea, rhinitis), bronchopulmonary tissues (asthma) and gastrointestinal tract (gastroenteritis). The reaction may cause a range of symptoms from minor inconvenience to death. The reaction usually takes 15 – 30 minutes from the time of exposure to the antigen, although sometimes it may have a delayed onset of 10-12 hours (Ghaffar, 2016).

Type II hypersensitivities are also known as cytotoxic hypersensitivities and may affect a variety of organs and tissues. The antigens are normally endogenous, although exogenous chemicals (haptens) which can attach to cell membranes and lead to type II hypersensitivity. Drug-induced hemolyticanemia, granulocytopenia and thrombocytopenia are examples. The reaction time is minutes to hours. Type II hypersensitivity are primarily mediated by antibodies of the IgM or IgG classes and complement. Phagocytes and K cells may also play a role (Ghaffar, 2016).

Type III hypersensitivity is also known as immune complex hypersensitivity. The reaction may be general such as serum sickness or may involve individual organs including skin like systemic lupus erythematosus, an Arthur reaction, kidneys, lupus-nephritis, lungs-aspergillosis, blood vessels-polyarteritis, joints-rheumatoid arthritis, or other organs. This reaction may be the pathogenic mechanism of diseases caused by many microorganisms.

Type IV hypersensitivity is involved in the pathogenesis of many autoimmune and infectious diseases (tuberculosis, leprosy, blastomycosis, histoplasmosis, toxoplasmosis, leishmaniasis, etc.) and granulomas due to infections and foreign antigens. Another form of delayed hypersensitivity is contact dermatitis such as with poison ivy, and heavy metals (Ghaffar, 2016).

5. As per your analysis, what type of hypersensitivity reaction is Janet experiencing?

Allergic disorders (type I hypersensitivity) associated with asthma, hay fever, and drug reactions, as well as parasitic infections (particularly with metazoan parasites) are often cited as causes. Allergic reactions can present as the patient having and increased number in eosinophilia is an absolute increase (more than 450/μL) in the total numbers of circulating eosinophils (McCance&Huether, 2014).

References

Ghaffar, A. (2016, April 2). Hypersensitivity reactions. Retrieved from http://www.microbiologybook.org/ghaffar/hyper00.htm

Mayo Clinic. (2019, April 20). Common cold Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/common-cold/symptoms-causes/syc-20351605

Mayo Clinic. (2017, May 2). Food allergy Symptoms and causes.Retrieved from https://www.mayoclinic.org/diseases-conditions/food-allergy/symptoms-causes/syc-20355095

Mayo Clinic. (2019, March 19). Hay fever symptoms and causes.Retrieved from https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039

McCance, K., Huether, S. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children, (7th Ed). Mosby, St. Louis, Missouri. [Vital Book File]. HASDOIHFOCINDLKCNBION

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2023 According to the American Diabetes Association 2011 25 8 million children and adults have been diagnosed

Nursing 2023 Discussion: Diabetes

According to the American Diabetes Association 2011 25 8 million children and adults have been diagnosed 2023 Assignment

According to the American Diabetes Association (2011), 25.8 million children and adults have been diagnosed with diabetes in the United States. Approximately 2 million more are diagnosed every year, with another 79 million people considered to be in a pre-diabetes state. These millions of people are at risk of several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. Since diabetes has a major impact on the health of millions of people around the world, it is essential for nurses to understand the pathophysiology and associated alterations of this disorder. In this Discussion, you compare two types of diabetes—diabetes mellitus and diabetes insipidus.

To Prepare

  • Review Chapter 19 in the Huether and McCance text and Chapter 18 in the  Hammer and McPhee text. Identify the pathophysiology of diabetes mellitus and diabetes insipidus. Consider the similarities and differences between resulting alterations of hormonal regulation.
  • Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Think about how the factors you selected might impact the diagnosis and prescription of treatment for these two types of diabetes.

Post an explanation of the pathophysiology of diabetes mellitus and diabetes insipidus. Describe the differences and similarities between resulting alterations of hormonal regulation. Then explain how the factors you selected might impact the diagnosis and prescription of treatment for these two types of diabetes.

Rubric:

Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources

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2023 a 23 year old Chinese American female freshman college student struggling with weight loss Assignment 3 4 pages not including title and

Nursing 2023 Advanced Health Assessment

a 23 year old Chinese American female freshman college student struggling with weight loss Assignment 3 4 pages not including title and 2023 Assignment

 

  a 23-year-old Chinese American female freshman college student struggling with weight loss.  

Assignment (3–4 pages, not including title and reference pages): 

Assignment Option 2: Child Health Case:
Include the following:

  • An explanation of the health issues and risks that are relevant to the child you were assigned.
  • Describe additional information you would need in order to further assess his or her weight-related health.
  • Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
  • Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
  • Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

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2023 Comment 1 As a passionate psychiatry nurse I picked my executive summary

Nursing 2023 Comments

Comment 1 As a passionate psychiatry nurse I picked my executive summary 2023 Assignment

Comment 1 

As a passionate psychiatry nurse, I picked my executive summary to be a suicide prevention program. Deaths by suicide have risen across the United States as reported by the Center for Disease Control in 2017. Suicide deaths are considered a crisis in the Mental Health profession. Suicide is not biased. It affects Caucasians, Africa-Americans, Indian, etc. It also affects the young, middle age, and elderly.  According to the CDC, over 45,000 reported suicides occurred in 2016 in the United States. Suicide was ranked the tenth
leading cause of death. 

There needs to be more programs for suicide prevention that is readily available and ready to help. The State of Alabama has a suicide hotline and several programs but they are in the big cities and that is not feasible for people who live an hour or two away. There needs to be more help all people who suffer mental illnesses.

Comment 2

I would like to describe differing approaches of nursing leaders and managers to issues in practice when discussing nurse-staffing ratios. This is a big issue in the country because aside from California, legally mandated nurse-staffing ratios do not exist. When it is discussed in the hospital now, nursing supervisors discourage it by telling nurses that it is not all it’s cracked up to be. Some hospitals can go under due to the need to staff appropriately. When talking to a nurse who has worked under both situations, she has said that the cost of healthcare ends up declining in a good way because nurses are making less overworked mistakes and patient-satisfaction is up. This can be the big difference between managers and leaders in the big picture of things. Managers will listen to nursing complaints of being overworked beyond safe circumstances and the manager will simply say, “this is what you signed up for when you became a nurse,” like we’re soldiers complaining about being shot at when we chose to be a soldier. We signed up for nursing to care for patients and participate in the optimization of their help. Leaders will listen to nursing complaints and ask themselves what can they do to help. At the end of the day, if more people were leaders, nursing shortages may not exist. Nurses would be happier and stay in their positions longer.  

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2023 Word count 1 800 10 penalty will apply for non adherence you cannot answer this paper in less

Nursing 2023 Nursing Professional Ethics

Word count 1 800 10 penalty will apply for non adherence you cannot answer this paper in less 2023 Assignment

 

Word count: 1,800 (+10% penalty will apply for non-adherence) – you cannot answer this paper in less than 1800 words. No work will be marked after 1980 words.

 

 

 

The purpose ofthisassignmenttaskis toidentifytheprinciplesofprofessional nursing practice, outlinetheethical andlegal frameworksforprofessional practice and apply the Ethical Decision Making Framework to a complex scenario to establish an ethically and legally sound decision. Remember toincorporate evidencedbasedpracticeinrelationtoquality patientcare.YouMUSTincludeinyourreferencing 4(four)ormore ofthefollowing;

 

 

 

·         Health PractitionerRegulation NationalLawAct 2010(WA)

 

·         NMBA Registered Nurse Standards for Practice 2016

 

·         NMBA NationalCode of Conduct for theRegistered Nurse2008

 

·         NMBA Codeof EthicsforRegistered Nurses2008

 

·         NMBA NationalFrameworkfortheDevelopmentof Decision Making Framework:  Scopeof Nursing Practice (2007)

 

·         NMBA ProfessionalBoundaries2010

 

 

 

Relevant Acts and Laws relating to the subject and health care practitioners – remember ALL your work must be referenced.

 

 

 

Use theModel for EthicalDecisionMaking (included in your instructions, available on Blackboard) to determine themost favorable outcome of your chosen scenario.

 

General Instructions

 

There should be attention to spelling grammar and punctuation, this work is an academic paper and needs to reflect your ability to analyse, reflect and articulate in the written form. Take time to study the marking guide to assist you with your focus. Note that there is no requirement for an introduction or a conclusion. There should be evidence of critical thinking. Citations within text and reference list should conform to APA 6th ed format.

 

If you feel that you require assistance with your academic writing skills there are many facilities on campus and online to support you. Below is the link to access what is available.

 

http://life.curtin.edu.au/learning-support/writing-skills.htm

 

Include a marking guide with your work. Put your name in full on your uploaded document; Surname first.

 

Using theModel for EthicalDecisionMaking (Kerridge, Lowe and McPhee, p85 2005) to determine themost favorable outcome:

 

Modelfor EthicalDecisionMaking

 

     Pleaseusetheseheadingswhenwritingyourcasestudy

 

·         The word count provided is only an example – it also shows the weighting of the importance of each section.

 

 

 

 

 

1.Clearlystatetheproblem: this should not be any more than 150 words (this is like an introduction)

 

 

 

Considertheproblemwithinitscontext; ethical, medical,socialandlegal considerations.

 

This should be a very brief summary of the issues as you see it – extract the issues:

 

 

 

o   What is the ethical ISSUE-what is the decision about?

 

o   What is the medical condition, just state this in a few lines

 

o   What is the social situation of the patient -is the person dependent, do they have support?

 

o   What appear (prima facie) to be the legal issues? Is it assault; is it the application of an Advanced Directive or informed consent for example?

 

Example: The medical issues for this patient (Mr S) are; Diabetes type1, depression and Heart Failure. The ethical issue for Mr S is that he is concerned about the lack of autonomy and justice when he is in hospital. Mr S’s social situation is that he lives with his wife and one daughter, he states he is a Catholic. The legal issues for Mr S are namely consent, guardianship and refusal of treatment. These issues will be explored throughout this paper. (80 WORDS – you don’t have to put the word count in each section just at the end of your work – this is just an example for you).

 

 

 

2.Get thefacts: this should not be any more than 350 words

 

 

 

Here you need to find out what are the facts of the case;  – what is the medical condition & history, examination, relevant tests (investigations), define the medical condition what is the pathophysiology of the condition/s – use scientific references

 

o   What is the prognosis?

 

o   What are the implications of the condition/s -for example is it acute, chronic, and degenerative? What type of progression or prognosis might be expected?

 

o   Are there any alternative treatments?

 

o   What social factors might have an influence – family input, social interaction

 

 

 

3.Considerthefourprinciples: this should not be any more than 250 words

 

 

 

 

 

o   You need to define each principle and relate the principle to the patient

 

o   Autonomy: whatarethe patientspreferences?

 

o   Beneficence:whatbenefitscanbe obtainedforthepatient?

 

o   Nonmaleficence:whatarethe risksandhowcantheybeavoided?

 

o   Justice:howarethe interestsofdifferentpartiesto be balanced?

 

 

 

4.Identifyethical conflicts: this should not be any more than 200 words

 

 

 

What are the ethical conflicts? To promote autonomy are we in conflict with beneficence (Autonomy vs Beneficence).

 

Explainwhytheconflictsoccur relating this to the patient andhowtheymayberesolved.

 

Ref the NMBA Code of Ethics / ICN Code of Ethics in this section

 

 

 

5.ConsidertheLaw: this should not be any more than 450 words

 

 

 

Identifyrelevantlegal conceptsandlawsandhowtheymightguidemanagement.

 

·         Consider: the Practice Standards – how they apply to the case study ie (NMBA Registered Nurse Standards for Practice 2016).

 

o   How does duty of care apply to the patient?

 

·         How does the Practice Standards relate to the Act?

 

·         You need to use the Acts (legislation) that apply to the case study for example:

 

o   Consent to Treatment – Age of Majority Act

 

o   Human Tissue and Transplant Act

 

 

 

6.Makingthe ethicaldecision:this should not be any more than 250 words

 

o   Clearlystatethe clinical ethicaldecisionand justifyiteg:

 

o   Specifyhowguidingprincipleswere balancedand why (i.e.justifythe decision). Use the information that you have in the Law and Get the Facts section to support your decision. MUST Reference

 

o   Takeresponsibilityforthedecision&providealternativemanagement – reference this!

 

 

 

7. Evaluate the decision and discuss the legal relevance and importance of accurate documentation: this should not be any more than 150 words

 

·         Identify how you would evaluate your decision-what is our fundamental tool for establishing the efficacy/outcome of an action/decision? – here you will research what does the literature say about evaluation – also use the NMBA Registered Nurse Standards for Practice 2016

 

o   State where you would document and why it is a fundamental practice in healthcare. Here you will research what the literature say about evaluation – also use the NMBA Registered Nurse Standards for Practice 2016.

 

 

 

Tip for 7. – Review Kozier and Erb’s Fundamentals of Nursing 2008 Vol 1 – Evaluating p 245 and Documentation and reporting Chapter 15 p255

 

 

 

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Further information:

 

·         A minimum of 18 references are required for this assessment.

 

·         Review the marking rubric when doing your assessment.

 

·         Good luck

 

 

 

 

 

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CASE SCENARIOS

 

 

 

SELECT ONE CASE SCENARIO AND APPLY THE MODEL FOR ETHICAL DECISION-MAKING

 

 

 

Case Study 1                          Mr. Alphonse

 

Mr Alphonse Martinez[1] a retired Italian man, married, his wife also retired and they have two grown up sons who still live at home. They are a close family who go to church every Sunday. Mr Alphonse had just recently made an Advanced Health Directive (AHD) that stated if he had another serious heart attack that he was not to be resuscitated. His wife and two sons were opposed to his Advanced Directive and instructed the staff to take no notice of the AHD.

 

Alphonse has been discharged from the coronary care unit (CCU) and placed in a step-down cardiac ward following his myocardial infarction (MI). While he had been in CCU the staff had felt that he had exaggerated his chest pain. That is, when they asked him to rate his pain from 0 – 10 he sometimes stated that it was 12 or 14. In response staff reacted in a rather disapproving manner.

 

During the first evening on the cardiac ward Alphonse asked Mark, one of the student nurses on clinical practice, to contact the hospital priest to come and see him and give him the last rites. Mark did so immediately and then went back to sit with Mr Alphonse.

 

Later Mark’s clinical supervisor (RN) called him to one side and asked why he was sitting with Mr Alphonse. Mark (student nurse) replied that Mr Alphonse was anxious and so he was sitting with him. The RN asked Mark “do you think you could be making him more anxious by sitting with him?” Mark replied that he didn’t think so, and he was only doing so until the priest came.

 

The RN then asked why the priest was coming, and Mark said that Mr Alphonse had asked for the priest, and so he had contacted him to come. The RN then said to Mark, “did you not think you should have told me what you had done” With that Mr Alphonse’s buzzer went and, turning to go back into the room, the RN and Mark saw Mr Alphonse have a cardiac arrest.

 

Despite vigorous and sustained effort Mr Alphonse could not be resuscitated.

 

 

 

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Case Study 2                                   Miss Mary-Jane

 

Mary-Jane is 14 years old; her parents are newly separated and they both work. She has three younger siblings and Mary-Jane does a lot of the child minding. She has been complaining of abdominal pain, moderate now severe and has some vaginal spotting (bleeding) for the past 24 hours. She presents to the emergency department at her local hospital with her parents who are concerned that their daughter is so unwell. Mary-Jane is looking pale, sweaty, light headed, nauseated and has some stomach bloating. You have taken her base line observations on admission and they are: temperature 37.8C, pulse 118bpm, BP 90/50, Respirations 28bpm, shallow breathing.  A possible diagnosis would be an ectopic pregnancy, and to rule this out a pregnancy test is essential. As the student nurse together with the Registered Nurse caring for Mary-Jane consider the legal and ethical issues, one being consent and the other confidentiality, these and others will need to be considered for Mary-Jane.

 

What are the rules surrounding mandatory reporting of sexual abuse?

 

 

 

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[1]Alphonse Martinez (Hawley, G. (p 212, 2007). Ethics in clinical practice: An interprofessional   approach. London.   Pearson Education Ltd.

 

 

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