History of Leukemia

Consider the following case scenarios:
Adhya is a 17 year old Indian-American female with a history of leukemia. The parents discussed a bone marrow transplant with the oncologist. The treatment could result on Adhya ‘s infertility.  The treatment has not been discussed with her neither the risk. She has not been given the option to look for methods to preserve fertility. What would you do as her Nurse practitioner in the Oncology practice.

A 10 year old is admitted to the hospital after a high fall in the State Fair. He has multiple internal injuries requiring surgery and possible blood transfusions. The parents who are Jehova Witness are refusing the transfusion and prefer to continue resuscitation with fluid. The parents offer you to sign a waiver of liability to the hospital in case of the child death.  You are the Emergency Department Nurse Practitioner coordinating the surgery. What’s your response?

Throughout this course, you have explored a wide range of health assessments and abnormal examination findings. Although you have predominantly focused on the procedural aspects of health assessment, this week, you will focus on ethical considerations that should be taken into account when advising patients or their families.
This week, you will consider how evidence-based practice guidelines and ethical considerations factor into health assessments. You will also evaluate health assessment concepts related to medical religious beliefs and infertility complications in oncology patients. 

Learning Objectives
Students will:
Apply evidence-based practice guidelines to make an informed healthcare decision
Apply ethical considerations to a health assessment response
Apply concepts, theories, and principles relating to sports physicals and well-child and well-woman examinations
Identify  concepts, theories, and principles related to advanced health assessment

Learning Resources

Required Readings (click to expand/reduce)

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
 
Chapter 24, “Sports Participation Evaluation”

In this chapter, the authors describe the process of a sports participation evaluation. The chapter also states the most common conditions encountered in a sports participation evaluation.

Chapter 25, “Putting It All Together”

In this chapter, the authors tie together the concepts introduced in previous chapters. In particular, the chapter has a strong emphasis on the patient-caregiver relationship.

Maron , B. J., Friedman, R. A., & Caplan, A. (2015). Ethics of preparticipation cardiovascular screening for athletes. Nature Reviews Cardiology, 12(6), 375–378. doi:10.1038/nrcardio.2015.21

Persad, G. (2018). Authority without identity: defending advance directives via posthumous rights over one’s body. Journal of Medical Ethics, 45(4), 249–256. https://doi.org/10.1136/medethics-2018-104971

Rourke, L., Leduc, D., & Rourke, J. (2017). Rourke Baby Record. Retrieved from http://rourkebabyrecord.ca/
 This website provides information on the Rourke Baby Record (RBR). The RBR supplies guidelines on growth and nutrition, developmental surveillance, physical exam parameters, and immunizations for well-baby and child care.

Savulescu, J., Giubilini, A., & Danchin, M. (2021). Global ethical considerations regarding mandatory vaccination in children. The Journal of Pediatrics, 231, 10–16. https://doi.org/10.1016/j.jpeds.2021.01.021

Zhang, H., Zhang, H., Zhang, Z., & Wang, Y. (2021). Patient privacy and autonomy: A comparative analysis of cases of ethical dilemmas in China and the United States. BMC Medical Ethics, 22(1). https://doi.org/10.1186/s12910-021-00579-6

Document: Final Exam Review (Word document)

Required Media (click to expand/reduce)

Module 4 Introduction
Dr. Tara Harris reviews the overall expectations for Module 4. Consider how you will manage your time as you review your media and Learning Resources for your Case Study Lab Assignment and your Final exam (3m).
Sports Participation Evaluation – Week 11 (12m)

Assignment 1: Lab Assignment: Ethical Concerns

Photo Credit: Getty Images/Maskot
As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?
In this Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

To Prepare
Review the scenarios provided by your instructor for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your scenarios.
Based on the scenarios provided:
Select one scenario, and reflect on the material presented throughout this course.
What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.
The Lab Assignment
Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

Please pick the case you would like to present.

CASE STUDY 1
The parents of a 16-year-old male is seen for his required physical examination before starting sports. His parents are opposed to him receiving any vaccines.
CASE STUDY 2
A 33-year-old woman with advanced stage breast cancer has been admitted to the emergency room with cardiac arrest. She is not married and her boyfriend accompanies her in the ambulance.
CASE STUDY 3
A 47-year-old man with Ulcerative Colitis has been admitted to the emergency room with an extreme abdominal pain.  He explains that he has not taken his medications for the last few months and does not have any medical or prescription insurance.
CASE STUDY 4
A single father has accompanied his 17 year old daughter to a women’s health clinic and has requested that the his daughter has a pregnancy test. The girl has not consented to the test and seems uneasy. 
CASE STUDY 5
A 15-year-old boy has come in for a sports physical after testing postive for Covid two months ago. He is coughing and has asthma but is not on maintenance medications. He has indicated that he doesn’t want to take medication everyday. 
CASE STUDY 6
A 19-year-old girl has come in for a routine check-up and has not yet received the Covid vaccine. Her family is very religious and believes that they are covered by their faith. 
CASE STUDY 7
A 60-year-old man who was diagnosed with inclusive body myositis several years ago is experiencing a rapid decline in his condition. He prefers to be stay home with hospice relief to receive end-of-life care, but his wife wants him to be admitted to an inpatient setting.

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