An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• Explain the process of immunosuppression and the effect it has on body systems.

By Day 7 of Week 2

Submit your Case Study Analysis Assignment by Day 7 of Week 2.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

Scenario for Case Study Week 2: A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon. 

Here is the introduction to the directions. I cannot copy and paste the directions from Week 2 into the same box as the case study as the site does not save if I go to another site to copy. So I am asking you to go into the Week 2 directions yourself for full details, please. 

Please go in to Week 2 for further instructions on writing this case study. This is due on the final day of Module 1, Week 2, which is a Sunday at 11:59 pm MT, as usual. The instructions are very clearly spelled out and like with the discussion, there are several points for you to include in your case study analysis. Since cancer is one of the topics in Module 1, this will be a good case. Please note the instructions specific to the page count, and the fact that you need a Title page, introduction, summary and references per Walden requirements. You may use your textbook as one resource (or another text) but please use at least 2 other scholarly articles that are 5 years old or less in your references. You may use more and you may also use very high-level websites (Walden discourages use of lower level websites, that are more accessible to the public). I hope this helps guide you in next week’s work. Please focus, though, on quality peer responses for this week’s work first. Thank you

 

The Child Abuse and Neglect Reporting Act (CANRA) pursuant to Penal Codes 11164 through 11174.3 is a body of California laws designed to protect children from suffering harm. Under this law, all individuals are required to report any suspected child abuse. Child abuse or neglect can be assessed by a physical injury or a bruise, sexual exploitation, negligent and mal treatment, willful harming and cruel, inhuman behavior with children are considered as child abuse.

To report a child abuse, one does not require to have an absolute proof of the abuse, rather any suspected signs and symptoms which can be seen in a child can be reported to law enforcement. The warning signs of an abuse could be inappropriate behavior of children, no love or attachment towards parents or care giver, inappropriate or extreme behavior. One does not have to disclose their identity to report abuse.

“An appropriate law enforcement agency may be one of the following:

• A Police or Sheriff’s Department (not including a school district police department or school security department).
• A County Probation Department, if designated by the county to receive child abuse reports.
• A County Welfare Department/County Child Protective Services.”

Professionals who are considered as mandated reporters are: school teachers, administrators, medical professional, day care facility employees, social workers etc.

Case Scenario: During home health visits to see an 80-y old bed ridden patient, a 5 year old grand daughter found performing minor household chores with inappropriate clothing and bruises on arms and slight redness on face. Step mother of the 5-year-old often seems very rude to the girl. Girl appeared dehydrated, unhygienic with same clothes on during each home health visits.

References:

https://www.wklaw.com/what-are-mandatory-reporting-laws

https://www.cde.ca.gov/ls/ss/ap/childabusereportingguide.asp

Comment 1

Principalism has really evolved into a practical approach for ethical decision-making which concentrates on common ground moral principles for autonomy, justice, beneficence, as well as non-maleficence (Döring, 2011). Principalism is also referred to as four-principal approach because of the four ethical principles which entail bioethics.  Let us look at these four principals.

The first one is respect for autonomy. This involves respect for what happens to person’s own bodies. This implies that patients may decide the kind of treatment one want as well as their right to refuse medications, treatment, and surgeries and this decision must be respected by caregivers (Döring, 2011). A good example is blood transfusion in a patient who is a Jehovah Witness believer. Even though the patient totally in need of blood, we must respect the fact that Jehovah Witness followers refuse blood transfusions. The other principle is nonmaleficence. This means doing no harm (Döring, 2011). It implies making of best medical decision as well as abiding by rules and regulations to ensure that patients are safe. This can even be small assignments such as hand hygiene as a way of preventing various infections. The other ethical principle beneficence which involves promoting all that is good (Döring, 2011). It involves striving to improve patient’s health based on the situation. The last principle is justice. This means that fairness within treatment and patient care need to be practiced to carry out justice. Distribution of resources should also be given equally.

These principles should be ranked the way I have written them, i.e., respect for autonomy, nonmaleficence, beneficence, and justice with the first one being the most important. Allowing patients to participate in their treatment and making their medical decisions is very important (CİVANER, 2016). This allows for an equal diplomatic approach to healthcare where both parties are involved. Even when we bring in Christian biblical narrative of creation, redemption, fall, and restoration, autonomy is important because it allows patients to choose what they want (CİVANER, 2016). Eve when God brought a human into the world, He enabled them to choose what is right for them and what is wrong for them.

Comment 2

The four principal approaches consist of four universal ethical principles, it consists of respect of autonomy which states to make autonomous decision that people can take and that should be respected. The other principal is non-maleficence states about an obligation to not harm anyone; beneficence is the action to benefit others and to simply improve any situation. Lastly, justice is the principle that works on the distribution of benefits which also engage risks and costs (Page, 2012). Thus, the principle of biomedical ethics claims that no one principal is more important than the other.  Above all it is the justice that should be given to all. We should be just towards others and always respect others, their decision and autonomy. 

It is first the justice, and then respect after that comes non-maleficence and then beneficence. On the biomedical ethical grounds in the United State, it merges all the other grounds in one sphere and also differentiates one from the other in certain aspects. Justice trumps over all other values or principals and it is the one above all. Therefore, in the case study autonomy has been held above all. The doctor did not pressurize the family to take any decision instead gave Mike and his wife full autonomy to decide the right path and take the call.         

 

Policy/Regulation Fact Sheet

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

• Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
• Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
• Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

• Briefly and generally explain the policy or regulation you selected.
• Address the impact of the policy or regulation you selected on system implementation.
• Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
• Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

Nutrition & Hydration/Persistent Vegetative State (PVS)

After studying the course materials located on Module 7: Lecture Materials & Resources page, answer the following: ON ATTACHMENT

1. Cure / care: compare and contrast.
2. Basic care: Nutrition, hydration, shelter, human interaction.
   • Are we morally obliged to this? Why? Example
3. Swallow test, describe; when is it indicated?
4. When is medically assisted N/H indicated?
   • Briefly describe Enteral Nutrition (EN), including:
     • NJ tube
     • NG tube
     • PEG
   • Briefly describe Parenteral Nutrition (PN), including:
     • a. Total parenteral nutrition
     • b. Partial parenteral nutrition
5. Bioethical analysis of N/H; state the basic principle and briefly describe the two exceptions.
6. Case Study: Terry Schiavo (EXCEL FILE on Module 7: Lecture Materials & Resources page). Provide a bioethical analysis of her case; should we continue with the PEG or not? Why yes or why not?
7. Read and summarize ERD paragraphs #:  32, 33, 34, 56, 57, 58.

• Cioffi, A. (2018, March 17). BIO 603 3 17 18 [Video file]. Retrieved from BIO 603 3 17 18 (Links to an external site.)
• Cioffi, A. (2019, April 6). BIO 603 CONSENT 4 6 19 [Video file]. Retrieved from BIO 603 CONSENT 4 6 19 (Links to an external site.)ATTACHMENT UPLOAD