Discussion Topic

       

Discussion:

1. Sanya, a 20-year-old woman from India who is attending a university in the United States, is seen by a nurse in a clinic for the first time when she is 16 weeks’ pregnant. This is an unplanned pregnancy, and Sanya tells the nurse that she wants an abortion. Sanya feels that, although abortion is discouraged by Indian culture unless it is necessary to save the mother’s life, she should terminate the pregnancy. Her boyfriend, the baby’s father, is a Caucasian American, but her parents have already arranged for her to marry an Indian man in India. Sanya would prefer to marry her American boyfriend.

• a. Using Leininger’s Sunrise Model, discuss the complexities of the cultural traditions and the woman’s situation
• b. How can the nurse offer support to the woman?

2.  Mrs. Trudy Jackson is a 75-year-old African American woman who has had hypertension for the past 15 years. She states that she doesn’t always take her pills because they cost $250 a month; if she feels ok, she doesn’t take them.

• a.   How do African American rates of hypertension and corresponding morbidity and mortality compare to other groups?
• b.   What is the nurse’s responsibility regarding educating Mrs. Jackson about her hypertension?
• c. What potential barriers may affect Mrs. Jackson’s health behavior?

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. 
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. 
• All replies must be constructive and use literature where possible.

Discussion on Informed Consent

Participation Requirement: You are required to post a minimum of three (3) times in each discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. on Wednesday.  On additional days, respond to your peers’ posts as well as additional faculty posts. Responses to peers must be posted by 11:59 p.m. on Sunday each week a discussion is due.

Step 1: Read the attached article entitled, “Informed Consent – The Joint Commission” 

Step 2: View the video entitled, “Nursing Fundamentals: Informed Consent, Advance Directives, Reporting and Nursing Documentation”https://www.youtube.com/watch?v=9u53jNI4qoU (Links to an external site.)

Informed consent is obtained after a client receives complete disclosure of all pertinent information provided by the provider regarding the surgery or procedure to be performed. The nurse may obtain informed consent only after the client verbalizes understanding of the potential benefits and risks associated with the surgery or procedure.

Elements of Informed Consent:

1. The individual giving consent must fully understand the procedure that will be performed, the risks involved, expected/desired outcomes, expected complications/side effects, and alternative treatments or therapies available.
2. Consent is given by a competent adult, legal guardian or designated power of attorney (DPOA), emancipated or married minor, parent of a minor, or a court order.
3. A trained medical interpreter must be provided when the person giving consent is unable to communicate due to a language barrier.
4. The nurse’s role is to witness the client’s signature and ensure the provider gave the necessary information and that the client understood and is competent to sign. If it has been identified that the client does not understand the procedure or is not competent to sign the informed consent, the nurse must STOP the process and the physician must be notified immediately.

A consultation occurs when a professional provides expert advice in a particular area and determines what treatment or services the client requires. The nursing intervention evolves around facilitating coordination with other health care providers throughout the continuum of care in order to protect the client from conflicting and potentially dangerous treatments.

A referral is a formal request for a special service by another care provider so that the client can access the care identified by the primary care provider or consultant. Some examples of referrals include physical therapy, wound care, and hospice. The nursing intervention continues to evolve around monitoring the client’s response and progress.

Directions: There are three scenarios that will be used in this discussion posting. You are all responsible for the initial discussion posting and then responding to one posting in the remaining scenarios. For example, my last name is Combs, therefore my initial discussion posting will occur from CASE #1. I will then be responsible for responding to one post from CASE #2 and one post from CASE #3.

CASE #1 (A to H); CASE #2 (I to Q); CASE #3 (R to Z)

CASE #1:

30-year-old male presents to the emergency department with RLQ pain and fever. Labs reveal an elevated white blood count. The surgical intern tells the patient that appendicitis is suspected and that the plan is to proceed with surgery to remove the appendix. He explains that the surgery is to be performed to prevent complications of appendicitis, including abscess formation, sepsis or even death. He goes on to explain the risks of surgery, including bleeding, infection and damage to adjacent organs. What additional information needs to be included in this consent? Provide an evidence-based reason for your answer.

1. Whether or not the intern would undergo the procedure in a similar circumstance.
2. Alternative to the surgery, including receiving antibiotics and monitoring the patient.
3. Name of the surgeon who will actually be performing the procedure.
4. A, B and C
5. B and C only

CASE #2:

33-year-old woman is in the operating room to undergo colectomy for ulcerative colitis. Patient was given appropriate information, and consented for the procedure. During the operation, a mass is identified involving the liver. Given the previous consent, it is acceptable for the surgeon to proceed further to either biopsy or excise the lesion. Provide an evidence-based reason for your answer.

1. True
2. False

CASE #3:

14-year-old girl presents to the emergency department, accompanied by her 10-month-old daughter and boyfriend. The boyfriend is the child’s father. Patient complains of severe lower abdominal pain, although she is afebrile, with normal laboratory values and normal vital signs. No cause of the pain is able to be delineated, and the plan is to take the girl to the operating room to perform a diagnostic laparoscopy. In this case, from whom should informed consent be obtained? Provide an evidence-based reason for your answer.

1. Patient
2. Patient’s parents
3. Patient’s boyfriend

Informed Consent – The Joint Commission.pdf

 

Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. Health disparities

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA 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 not required to submit this assignment to LopesWrite.

PLEASE FOLLOW THE INSTRUCTION BELOW 

FOLLOW THE RUBRIC DETAILS  ATTACHED

ZERO (0) PLAGIARISM

FIVE RERENCES  LESS THAN FIVE YEARS OR NOT UP TO FIVE YEARS

PLEASE FOLLOW THE APA 7TH  WRITING FORMAT/STYLE.

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks. 

 For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

  

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

• By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
• How would your communication and interview techniques for building a health history differ with each patient?
• How might you target your questions for building a health history based on the patient’s social determinants of health?
• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
• Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
• Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

• Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Analyze communication techniques used to obtain patients’ health histories based upon social determinants of health

Analyze health-related risk

 Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information

 This is case assignment for this week’s Discussion listed below :

  38-year-old Native American pregnant female living on a reservation