ethical decision

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Eleanor Thompson, a 72-year-old woman, has been battling an aggressive form of ovarian cancer for the past three years. Despite undergoing multiple rounds of chemotherapy and radiation, her condition has deteriorated, and she is now experiencing severe pain and suffering. Eleanor’s oncologist, Dr. Samuel Martinez, has presented the family with the option of another experimental treatment, but he has also suggested considering transitioning to palliative care. Eleanor’s family is deeply divided on the decision. Her eldest daughter, Maria, believes that every possible treatment should be pursued, holding onto hope for a miracle. She argues that her mother has always been a fighter and would want to continue the battle against her illness. On the other hand, Eleanor’s son, Michael, feels that his mother has suffered enough. He believes that transitioning to palliative care would allow her to spend her remaining days in comfort and peace. Caught in the middle is Eleanor’s husband of 50 years, Robert. He is torn between wanting to honor his wife’s fighting spirit, desiring to ease her pain, and the painful finality of either decision. The healthcare team must navigate a complex ethical landscape. Beneficence, the principle of doing good, pushes the team to consider what would truly benefit Eleanor in terms of quality of life. Non-maleficence, or “do no harm,” raises questions about the potential suffering Eleanor might endure with further aggressive treatments. Lastly, the principle of justice requires the team to treat Eleanor fairly and equitably, ensuring her needs are met regardless of family disagreements.
Using the case study above, answer the questions below.

  1. Summarize the facts in the selected case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
    • Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
    • Identify who is involved or affected by the ethical problem or issue.
    • Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
      • Apply the three components outlined in the Ethical Decision-Making Model media.
    • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
      • Describe the factors that contributed to the problem or issue and explain how they contributed.
  2. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
    • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
      • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
      • Review the Think Critically About Source Quality resource.
        • Assess the credibility of the information source.
        • Assess the relevance of the information source.
  3. Discuss the effectiveness of the communication approaches present in a case study.
    • Describe how the health care professional in the case study communicated with others.
    • Assess instances where the professional communicated effectively or ineffectively.
    • Explain which communication approaches should be used and which ones should be avoided.
    • Describe the consequences of using effective and non-effective communication approaches.
  4. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
    • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
    • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
    • Discuss the key lessons this case provides for health care professionals.
  5. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
    • Describe the proposed solution.
    • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
    • Discuss how likely it is the proposed solution will foster professional collaboration.
  6. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
    • Apply the principles of effective composition.
    • Determine the proper application of the rules of grammar and mechanics.
  7. Write using APA style for in-text citations, quotes, and references.
    • Determine the proper application of APA formatting requirements and scholarly writing standards.
    • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

nursing

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 What is your definition of spiritual care? How does it differ or accord with the description given in the topic readings? Explain. 

Nutrition & Hydration/Persistent Vegetative State (PVS)

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

  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.

Submission Instructions:

  •  is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
  • If references are used, please cite properly according to the current APA style. 

Week 6 ion channel —2 Peer Response 600w. due 10-12-23

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Week 6 ion channel —2 Peer Response 600w. due 10-12-23

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

Please be sure to validate your opinions and ideas with citations and references in APA format.

IA

This is a very interesting case since Sam is only 19 years old and has a history of major depressive disorder (MDD) and also generalized anxiety disorder (GAD). At a glance, I noticed that his behavior has highs and lows since he has gone from being violent by throwing a chair at a store window to having a “resounding moment” where everything makes sense. Among many other clues, this leads me to believe Sam can be newly diagnosed with bipolar disorder with manic episodes.

After consulting our DSM-5-TR book on page 140, I also realized Sam presents multiple symptoms that represent the diagnosis of bipolar disorder. To start Sam preceded a “psychotic breakdown” along with a history of MDD. He has also presented physiologic changes like diminished sleep, and other signs, and symptoms of a manic episode (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022). It also appears he is more talkative than usual by engaging his colleagues for long hours in conversation. Adding on to his symptoms it also appears he has engaged in high-risk behaviors such as drinking and sexual relations which was not his norm before. He has thought of himself as being better than the professors which match the ideas of grandiosity.

At first, I wasn’t sure which medication to prescribe, but it seems he would benefit from lithium since lithium is an antimanic medication primarily used to treat bipolar disorder(Lithium, 2022). Sources such as MedlinePlus indicate lithium is a mood stabilizer and works by releasing dopamine and serotonin in the brain (Lithium: MedlinePlus Drug Information 2023). Just like this case, I have seen many but now I see things differently since I know more in-depth the signs and symptoms as well as researching the proper medication.

References:

Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th ed.). (2022). . American Psychiatric Association Publishing.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: The Prescriber’s Guide (7th ed.). Cambridge University Press.

Townsend., K. I. M., Mary C. (2020). Essentials of Psychiatric Mental Health Nursing, 8th edition. F.A. Davis.

MAM

Week 6, Medication for Bipolar Disorders

What diagnosis do you believe may apply to this individual?

The patient is a young boy presenting with a 'psychotic break,' characterized by reckless behaviors, sudden and unconventional decision-making (such as changing his major in university), distractibility, reduced need for sleep, a heightened sense of knowledge and grandiosity (believing he can teach courses in the university), and unusual beliefs regarding the nature of reality and his newfound appreciation for life. He is also engaging in high-risk behaviors, including excessive drinking, sexual activity, violence, increased spending, and initiating numerous projects without completing any. These symptoms are indicative of a manic episode (if they present more than a week).

Considering the patient's history of Major Depressive Disorder (MDD) and anxiety disorder, the diagnosis of Bipolar I Disorder (BPD) has been established. It is crucial to first rule out any medical problems, brain trauma, substance abuse, and other mental disorders that may be included in the differential diagnosis of BPD. The primary distinction between bipolar I and II lies in the nature of the manic or hypomanic episodes. In bipolar I disorder, individuals experience full manic episodes that typically last for at least one week. On the other hand, bipolar II disorder is characterized by hypomanic episodes, which are milder in intensity and shorter in duration, lasting no more than four days (Stahl, 2021).

Beyond this key difference, there are also variations in the clinical course and family history associated with these two subtypes. Individuals with bipolar II disorder tend to receive their diagnosis later in life, and their first experience of hypomania occurs at an older age compared to those with bipolar I disorder. These distinctions in age of onset and diagnostic patterns contribute to the differentiation between bipolar I and II disorders (Brancati et al., 2023).

Manic often presents with the feeling of being extremely important and having a very high opinion of oneself, sometimes to the point of having false beliefs about one's capabilities (Howse et al., 2023). In this case, the patient believes he is capable of teaching at the university. An experienced Psychiatric Mental Health Nurse Practitioner (PMHNP) can conduct a thorough history assessment to determine whether the psychosis is linked to brain traumas, substance use, schizoaffective disorders, or BPD.

What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?

When the patient is diagnosed with Bipolar disorder, it indicates the need for mood stabilizers. Various mood stabilizers are available, including Lithium, Lamotrigine, Valproic Acid, and Carbamazepine. According to Stahl (2021), Lithium is considered the foundational and standard treatment for bipolar disorder and acute mania. However, this medication comes with several potential side effects, such as tremors, nephrotoxicity (Diabetes Insipidus), hypothyroidism, dyspepsia, nausea, vomiting, diarrhea, weight gain, hair loss, acne, sedation, decreased cognition, and incoordination. It can also lead to EB Stain anomalies in the fetus if taken during pregnancy.

Lithium additionally has a very low therapeutic index, signifying that the lethal dose of this medication is very close to the therapeutic level in the blood. Therefore, monitoring of blood levels of this medication is crucial throughout the treatment process. Regular assessments of kidney function, thyroid hormone levels, and electrolytes are also necessary. Lithium effectively stabilizes mood and reduces the severity of manic episodes (Stahl, 2021). Alongside medication, psychotherapy, such as cognitive-behavioral therapy or family-focused therapy, plays an essential role in treatment. It is equally important to educate the patient's family members about the disease and the treatment process.

References

Brancati, G. E., Nunes, A., Scott, K., O’Donovan, C., Cervantes, P., Grof, P., & Alda, M. (2023). Differential characteristics of bipolar I and II disorders: a retrospective, cross-sectional evaluation of clinical features, illness course, and response to treatment. International Journal of Bipolar Disorders, 11(1), 25. https://doi.org/10.1186/s40345-023-00304-9

Howse, J., Kanter, J., Muhammad, Q. C., & Wojcik, K. D. (2023). Mood disorders with psychotic features: Diagnostic considerations and treatment challenges. Psychiatric Annals, 53(4), 160-165. https://doi.org/10.3928/00485713-20230313-01Links to an external site.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).

m4

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please follow all directions

Health

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Is the magic pill documentary’s by Peter Attia  description of the current food industry accurate? Research at least one other authoritative source that is external to the documentary to defend your answer. Be sure to fully and properly cite your source of information. 

Are the recommendations made by the American Heart Association and the National Institute of Health based on biased research? Find at least one other authoritative source that is external to the documentary to defend your answer.



please review

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 paragraph

Lymphadenitis

Phlebitis

Myocardial infarction

Cardiac arrest

Deep venous thrombosis

 

  • Your assignment will be run through TurnItIn to check for plagiarism. 

WORKPLACE ENVIRONMENT ASSESSMENT

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Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.

In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment.

To Prepare:

  • Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
  • Review the Work Environment Assessment Template*.
  • Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
  • Select and review one or more of the following articles found in the Resources:
    • Clark, Olender, Cardoni, and Kenski (2011)
    • Clark (2018)
    • Clark (2015)
    • Griffin and Clark (2014)

*Template completed in the Week 7 discussion should not be submitted with this assignment.

The Assignment (3-6 pages total):

Part 1: Work Environment Assessment (1-2 pages)

  • Review the Work Environment Assessment Template you completed for this Module’s Discussion.
  • Describe the results of the Work Environment Assessment you completed on your workplace.
  • Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
  • Explain what the results of the Assessment suggest about the health and civility of your workplace.

Part 2: Reviewing the Literature (1-2 pages)

  • Briefly describe the theory or concept presented in the article(s) you selected.
  • Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
  • Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.

Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)

  • Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
  • Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment.

Nursing Homework

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Purpose

The Topic Search Strategy paper is the first of three related assignments. The purpose of this initial paper is to briefly describe your search strategies when identifying two articles that pertain to an evidence-based practice topic of interest.

Course outcomes: This assignment enables the student to meet the following course outcomes.

1. Examine the sources of knowledge that contribute to professional nursing practice. (PO 7)

2. Apply research principles to the interpretation of the content of published research studies. (POs 4 and 8)

Preparing the assignment:

Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

a. Paper should be 3-4 content pages in length. Title and reference pages are required but are excluded from 3-4 -page length.

2) The paper will include the following sections:

a. Clinical Question

· Describe the problem. What is the focus of your work?

· Explain the significance of the problem in terms of patient outcomes. What health outcomes result from your problem? Or what statistics document this is a problem? You may find support on websites for government or professional organizations.

· PICOT question in support of the group topic.

· State the purpose of your paper. What will your paper do or describe? This is like a problem

statement. “The purpose of this paper is to . . .”

b. Levels of Evidence

· Identify the type of question being asked (therapy, prognosis, meaning, etc.).

· What is the best type of evidence to answer that question (e.g., RCT, cohort study, qualitative study, etc.)?

c. Search Strategy

· List search terms and results.

· Databases used (start with the CU library). Link your search with the PICOT question described above.

· Refinement decisions. As you did your search, what decisions did you make in refinement to get your required articles down to a reasonable number for review? Were any limits used? If so, what?

· Identification of two (2) most relevant articles (primary sources published within the last 5 years).

d. Format

· Correct grammar and spelling.

· Include a title page.

· Use of headings for each section.

· Clinical Question, Levels of Evidence, Search Strategy, and Conclusion

· Adheres to current APA formatting and guidelines.

· 3-4 pages in length, excluding title and reference pages.

NR449 Evidence-Based Practice

RUA: Topic Search Strategy Guidelines

NR449 Evidence-Based Practice

RUA: Topic Search Strategy Guidelines

© 2023 Chamberlain University. All Rights Reserved

NR449_RUA_Topic_Search_Strategy_NOV23 1

© 2023 Chamberlain University. All Rights Reserved

NR449_RUA_Topic_Search_Strategy_NOV23 1

© 2023 Chamberlain University. All Rights Reserved

NR449_RUA_Topic_Search_Strategy_NOV23 1

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Reflection Scenario Template

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 1) Watch the entire scenario. In the scenario assignment, you are asked to reflect on responses to the presented scenario. 

2) Fill out the template attached below

3) Compose the last question on the template reflection in a Word document and be sure to address, at a minimum, the following questions:

*Why do you feel the way you do about the issue presented?

*Of the four responses offered in the scenario, which do you think is the most ethical and why?

*Which ethical theory would you use to support your stance? Why does this theory work?

4)  Support your conclusions with evidence and specific examples from the textbook, including a minimum of one theory of ethics to defend your stance.