Jessica is a 32 y/old math teacher who presents to the ER with a friend for evaluation of sudden decrease of vision in the left eye. She denies any trauma or injury. It started this morning when she woke up and has progressively worsened over the past few hours. She had some blurring of her vision 1 month ago and thinks that may have been related to getting overheated, since it improved when she was able to get in a cool, air-conditioned environment. She has some pain if she tries to move her eye, but none when she just rests. She is also unable to determine colors. She denies tearing or redness or exposure to any chemicals. Nothing has made it better or worse.

She is normally healthy. She had chickenpox at age 10 and a tonsillectomy/adenoidectomy at age 11. She has no medical problems. She has never been hospitalized. She has four children, all spontaneous vaginal deliveries.  She completed a bachelor’s degree in mathematics and a master’s degree in education. She quit smoking 10 years ago (two packs daily for 5 years); she drinks an occasional wine cooler, and she denies illicit drug use. Her father has a coronary artery disease (he had a stent placed at age 67) and a mother with hypertension.

She denies fever, chills, night sweats, weight loss, fatigue, headache, changes in hearing, sore throat, nasal or sinus congestion, neck pain or stiffness, chest pain or palpitations, shortness of breath or cough, abdominal pain, diarrhea, constipation, dysuria, vaginal discharge, swelling in the legs, polyuria, polydipsia, and polyphagia.

Patient is alert; she appears anxious. BP 135/85 mm Hg; HR 64bpm and regular, RR 16 per minute, T: 98.5F. Visual acuity 20/200 in the left eye and 20/30 in the right eye. Sclera white, conjunctivae clear. Unable to assess visual fields in the left side; visual fields on the right eye are intact. Pupil response to light is diminished in the left eye and brisk in the right eye. The optic disc is swollen. Full range of motions; no swelling or deformity. Mental status: Oriented x 3. Cranial nerves: I-XII intact; horizontal nystagmus is present. Muscles with normal bulk and tone; Normal finger to nose, negative Romberg. Intact to temperature, vibration, and two-point discrimination in upper and lower extremities. Reflexes: 2+ and symmetric in biceps, triceps, brachioradialis, patellar, and Achiles tendons; no Babinski.

Instructions:

Make a whole history and physical examination in a comprehensive manner with all its elements included: CC, HPI, PMH, FH, SH, MEDICATIONS, ALLERGIES, ROS PER APPARATUS OR SYSTEMNS, HEAD TO TOE PHYSIACL EXAMINATION PER SYSTEMS ( write your presentation in H&P format no paragraph format).

          Based on this information, what is your presumptive nursing diagnosis? All nursing diagnosis that apply to the case written in NANDA format related to … and evidence by…., NO MEDICAL DIAGNOSIS.

  Teaching plan and nursing care plan per each nursing diagnosis on this case.

       Requirements.

    1- All written assignment and documentations must be  in APA 6th edition format.

    2- Double spaces, minimum 4 pages long , minimum 3 up to date bibliography. (UP to date means last 3 years.), Note: you can use your test book as bibliography too, bibliography have to be written in APA format.

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and acceptance of a diversity of faith expressions.

The purpose of this paper is to complete a comparative ethical analysis of George’s situation and decision from the perspective of two worldviews or religions: Christianity and a second religion of your choosing. For the second faith, choose a faith that is unfamiliar to you. Examples of faiths to choose from include Sikh, Baha’i, Buddhism, Shintoism, etc.

In your comparative analysis, address all of the worldview questions in detail for Christianity and your selected faith.  Once you have outlined the worldview of each religion, begin your ethical analysis from each perspective.

In a minimum of 2,000 words, provide an ethical analysis based upon the different belief systems, reinforcing major themes with insights gained from your research, and answering the following questions based on the research:

1. How would each religion interpret the nature of George’s malady and suffering? Is there a “why” to  his disease and suffering? (i.e., is there a reason for why George is ill, beyond the reality of physical malady?)
2. In George’s analysis of his own  life, how would each religion think about the value of his life as a person, and value of his life with ALS?
3. What sorts of values and considerations would each religion focus on in deliberating about whether or not George should opt for euthanasia?
4. Given the above, what options  would be morally justified under each religion for George and why?
5. Finally, present and defend  your own view.

Case Study: End of Life Decisions

George is a successful attorney in his mid-fifties. He is also a legal scholar, holding a teaching post at the local university law school in Oregon. George is also actively involved in his teenage son’s basketball league, coaching regularly for their team. Recently, George has experienced muscle weakness and unresponsive muscle coordination. He was forced to seek medical attention after he fell and injured his hip. After an examination at the local hospital following hisfall, the attending physician suspected that George may be showing early symptoms for ALS (amyotrophic lateral sclerosis), a degenerative disease affecting the nerve cells in the brain and spinal cord. The week following the initial examination, further testing revealed a positive diagnosis of ALS. ALS is progressive and gradually causes motor neuron deterioration and muscle atrophy to the point of complete muscle control loss. There is currently no cure for ALS, and the median life expectancy is between three and five years, though it is not uncommon for some to live 10 or more years. The progressive muscle atrophy and deterioration of motor neurons leads to the loss of the ability to speak, move, eat, and breathe. However, sight, touch, hearing, taste, and smell are not affected. Patients will be wheelchair bound and eventually need permanent ventilator support to assist with breathing. George and his family are devastated by the diagnosis. George knows that treatment options only attempt to slow down the degeneration, but the symptoms will eventually come. He will eventually be wheelchair bound, and be unable to move, eat, speak, or even breathe on his own. In contemplating his future life with ALS, George begins to dread the prospect of losing his mobility and even speech. He imagines his life in complete dependence upon others for basic everyday functions, and perceives the possibility of eventually degenerating to the point at which he is a prisoner in his own body. Would he be willing to undergo such torture, such loss of his own dignity and power? George thus begins inquiring about the possibility of voluntary euthanasia.

Support your position by referencing from lectures, the Bible, and the textbooks for each religion. Each religion must have a primary source included. 

A total of six references are required according to the specifications listed above. Incorporate the research into your writing in an appropriate, scholarly manner.

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

Peer response: need 1 reference with in text citation, minimum 100 words for each    

Education in family planning, promoting rights to birth control is what nurse activist Margaret Sanger devoted her entire life to. Her devotion caused her to be jailed for distributing contraceptives to immigrant women from a clinic (Nickitas, Middaugh & Aries, 2014). Margaret Sanger was a nurse that worked in poverty stricken neighborhoods where she could provide education to woman regarding their rights to birth control, family planning and the importance of using contraceptives to decrease unwanted pregnancies. She had many people working with her to help spread the word for woman’s rights. The Arkansas Nurses association held a convention to help nurses gain awareness for education, gain knowledge on nursing theory and help promote professional growth and development (Arkansas Nurses Association, 2014).

The policy can change when it passes through legislation and decided by the elected officials enact it into law. Nurses can help improve the decision-making process by working outside the government by forming coalitions to influence the decision-making process (Nickitas, Middaugh & Aries, 2014). Nurses should advocate for patients by using their critical thinking skills when trying to influence within the organization.

A policy that need advocating for is nursing staff shortages. Patients seem to be more critical when being admitted to the hospital. With short staff it becomes difficult to care for patients the way they deserve. Patients have rights when it comes to receiving care, receiving quality effective care is important to positive health outcomes. Patient safety is compromised with every shift that is short staffed. Many errors occur when nurses must work shorthanded (Westrick, 2014).

References

Arkansas Nurses Association 101th Annual ARNA Convention. (2014). Arkansas Nursing News, 10(4), 7-14.

Nickitas, D. M., Middaugh, D. J. & Aries, N.  (2014). Policy and politics for nurses and other health professionals.  (2nd ed.).  Jones & Bartlett

 Westrick, S. J. (2014). Essentials of Nursing Law & Ethics. (2nd ed.). Burlington, MA. Jones & Bartlett

Peer response: need 1 reference with in text citation, minimum 100 words.   

When trying to influence policy changes or making policies it is important to understand the interest groups, their influence, and the stakeholders involved (Mund, 2012). The policy framework is the identification of the problem and the causes of the problem (Weston, Brewer, & Peterson, 2012). When an idea is thought for the problem then it is added to an agenda. Elected officials then decide on policies through a legislative process (Nickitas, Middaugh, & Aries, 2016). Then the policy can be implemented as an extension of the policy creation and process.

Nurse Sanger did not want any more women dying from illegal abortions. She started to organize protests to bring attention to the issue and health care inequality women were receiving (Nickitas, Middaugh, & Aries, 2016). This was challenging given the time in history this was taking place. Given the time in history she would have to make compelling arguments for women and birth control (Nickitas, Middaugh, & Aries, 2016). A turning point was when Nurse Sager was arrested in 1917 for distributing contraceptives to immigrant women from a clinic while demanding for services for the poor that are given to the middle class (Nickitas, Middaugh, & Aries, 2016). Her intentions were to shed more light on reproductive services and women’s rights. It worked, physicians were able to prescribe contraceptives and freestanding facilities were built (Nickitas, Middaugh, & Aries, 2016). In 1936 Nurse Sanger won a federal court decision allowing physicians to import contraceptives using the federal mail system (Nickitas, Middaugh, & Aries, 2016). She continued to shape public health initiatives. She lobbied men, women, organizations, and businesses for public health and birth control (Nickitas, Middaugh, & Aries, 2016). She spread her word through writing books and giving lectures across the world. She lobbied at the state legislators for women’s health clinics (Nickitas, Middaugh, & Aries, 2016). She coined the terms birth control and family planning. In 1952 she expanded to London and founded the International Planned Parenthood Federation (Nickitas, Middaugh, & Aries, 2016). Before her death she was able to see many achievements for family planning.     

References

Mund, A. R. (2012). Policy, practice, and education. AANA Journal, 80(6), 423-426.

Nickitas, D.M., Middaugh, D.J., & Aries, N. (2016). Policy and politics for nurses and other health professionals (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Weston, M. J., Brewer, K. C., & Peterson, C. A. (2012). ANA principles: The framework for nurse staffing to positively impact outcomes. Nursing Economic$, 30(5), 247-252.

• Posted: 2 years ago
• Due: 08/10/2017
• Budget: $15