Discuss how emerging technologies impact patient care and the storage of health information. What is one ethical or legal issue related to EHRs that can impact registered nursing practice? According to HIPAA, protected health information (PHI), and the requirements for privacy and confidentiality, what is one measure you can implement in your practice to protect patient privacy and confidentiality?

REPLY TO DISCUSSIONS

Herbert is a 75-year-old male who tells you he has been bothered by a “runny nose” for several weeks. He has a history of hypertension and hyperlipidemia and has been taking Sudafed for his runny nose, which he says has been working well. His vital signs today are 150/86 P 89 P02 98%. What recommendations would you make for him regarding medication treatment of his rhinitis? Plz answer appropriately

A 24-year-old male college student was presented at the ESU health clinic. He looked tired and pale. He presented because of a high fever and chest pain. He was afraid he was having a heart attack (a bad week of exams). He was examined immediately by the PA and an EKG strip was run. He had no evidence of acute heart problems. The attending physician visited the patient. He obtained the following history from the past 36 hours. The patient had a tight cough. He had significant muscle aches and pains. He had a bad headache and a fever of 101-103F.

The physician ordered a chest x-ray. It did not show any significant consolidated inflammation suggestive of pneumonia. The patient showed significant nasal drainage and a moderately tight, but productive cough on physical exam. He had a fever of 101F and generally inflamed mucous membranes. A rapid Strep test showed no evidence of Streptococcal infection and his tonsils and adenoids had been removed.

1. What type of infection do you believe he has? what microorganism is causing this disease?

2.  From the complaint and physical examination, which of the symptoms lead you to your choice of agent? how did you come to that conclusion?

3. From the history, which of the information confirmed your choice? What is the treatment for this illness/disease?

4. Which of the following is most likely to follow this infection? How did you come to that solution of the treatment? In other words, why is it that treatment?

 

Please reference and cite and also keep both studies separated and numbered! And keep the answered questions and explanation together, about a paragraph for each question. thank you!

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Case study 6

 

A 70-year-old patient with Alzheimer’s disease was brought to the emergency room by the staff of a local nursing home. He presented as lethargic with a sallow complexity. He had an admission temperature of 102.4F and a respiratory rate

of 33/minute. During respiration, the right side of his chest moved better than the left. He showed dense consolidation of the lower lobe of the left lung on physical exam. A sputum sample revealed blood and a greenish color.

A chest x-ray showed tight consolidation of the left lung with evidence of formation of cavities in the lung tissue from cytotoxic damage. The patient complained of chills in the exam room, combined with his fever. A smear of his

sputum demonstrated no acid-fast bacteria.

 

1. What type of infection do you believe he has? what microorganism is causing this disease?

2.  From complaint and physical examination, which of the symptoms lead you to your choice of agent? how did you come to that conclusion?

3. From the history, which of the information confirmed your choice? What is the treatment for this illness/disease?

4. Which of the following is most likely to follow this infection? How did you come to that solution of the treatment? In other words, why is it that treatment?
Please reference and cite and also keep both studies separated and numbered! And keep the answered questions and explanation together, about a paragraph for each question. thank you!

Beneficence was defined as “The principle of beneficence entails a moral obligation to help other persons (for example, obligations of health professionals to assist patients) or to provide benefits to others. Beneficence involves both the protection of individual welfare and the promotion of the common welfare.” (Coughlin, 2008) Let us examine the topic of Beneficence in relation to the ethical dilemma below. At this point, I understand that it may be difficult to explain both individual and group dilemmas relating to public health ethics – which is exactly why I chose this case study. There are some clear individual ethical issues and tensions present due to the nature of the scenario and how as public health officials we have to act in the best interest of society as a whole.

For this case study, you will need to tie in previous knowledge of public health and ethics related to research. Beneficence is not the only ethical tension in question here, but it is the focus to make sure you are using that lens to guide your best course of action. Public Health Ethics Case Study #1 Beneficence PUBH 3420 Introduction: [Three years ago, Jonathan, aged 23] decided to participate in a large-scale biobanking project that was exploring how environment, lifestyle, and behavior contribute to the development of cancer. Very enthusiastic about this project and in solidarity with his mother-in-law who had been diagnosed with breast cancer, Jonathan provided blood and saliva samples to the PreHealth Project based in Winnipeg, Manitoba. At the assessment center, hosted by the local hospital, Jonathan was asked to do a lifestyle questionnaire and provide authorization for the retrieval of pertinent information from his medical records.

The consent form he signed before providing any samples or authorizing the retrieval of any data mentioned that both his data and samples would be stored securely for 50 years and that access would only be provided to researchers partaking in cancer research who had previously obtained the necessary scientific and ethical approval. The PreHealth Project is affiliated with a university in the region and the Research Ethics Board (REB) of that university’s Faculty of Medicine is in charge of approving any access requests. After providing his data and samples, Jonathan decided to leave the country to pursue a graduate degree in France without updating his new address with the PreHealth Project. Case: The Canadian government has recently declared a public health emergency following the propagation of a mutated strain of the Ebola virus. Every province in the country is striving to provide the necessary care to individuals affected by the latest strand of the virus and the same level of intense activity is seen in the research setting.

In Manitoba, research has focused mainly on small groups of people considered most at risk of developing serious symptoms related to the new Ebola virus. To prevent future outbreaks, however, many researchers in the province believe it is necessary to undertake a larger study of genetic factors contributing to the development of severe symptoms. Only a study involving thousands of subjects could identify any genetic factors involved in this propagation, but no resource of this size is currently available for research on the new Ebola virus. Moreover, setting up a biobanking project specific to the Ebola virus would require a considerable amount of both time and funds before it could be effective and usable by medical researchers. This insufficiency is prompting several researchers to request access to biological materials and genetic information already stored in various pre-existing population biobanks for use as control groups. The university’s REB has received one such request. After a long debate, its full membership decided to authorize a Canadian researcher to access the data and samples collected by the PreHealth Project. The declared public health emergency led the REB members to decide that Public Health Ethics Case Study #1 Beneficence PUBH 3420 the proposed research is essential and that the infringement to the participants’ consent — that their data and samples only be used for cancer research — was justified in these exceptional circumstances.

In normal circumstances, participants would have had to re-consent for such secondary use of their data and samples. On Jonathan’s return to the country, he learned through local media that PreHealth’s data and samples will be used for studies on the mutated strain of the Ebola virus. He felt concerned that his samples would be used for a purpose other than what he was informed of during the consent process. He also feels a bit betrayed by the project he so eagerly participated in on altruistic grounds. Jonathan decides to complain to the Faculty of Medicine of the university in question and is contemplating legal action for improper use of his data and samples. Questions to guide your thinking: 1. What are the competing ethical issues at play? 2. What are the benefits and/or disadvantages for researchers to use a population biobank established for research on cancer to study genetic aspects of the mutated strain of the Ebola virus? 3. What possible repercussions could this dispute have on future participation in the PreHealth Project? 4. Do you agree with the decision made by the REB? If yes, why? If not, what would you have decided if you were an REB member?

Would like assistance in thoroughly answering these questions. My instructor told me I did not answer the question correctly or detailed. Please if you have read the book (I’m Here, Compassionate Communication in Patient Care by Marcus Engel) and know the nursing theories I would like help. My initial response to each question is below.

1. Marcus Engel described his experience as a patient in  I’m Here, Compassionate Communication in Patient Care. Consider how Patricia Benner’s From Novice to Expert Theory applies to Mr. Engel’s experiences.

2. Describe how the Benner’s theory related to Mr. Engel’s experience.

3. How would the care received by Mr. Engel have been improved by applying Benner’s theory?

 My initial response: 1. Marcus Engel described his experience as a patient in  I’m Here, Compassionate Communication in Patient Care. Consider how Patricia Benner’s From Novice to Expert theory applies to Mr. Engel’s experiences.

Patricia Benner’s From Novice to Expert theory is about understanding nursing knowledge and taking care of patients. Benner’s theory applies to Marcus Engel’s experiences because he was a patient. His nurse was able to show him compassion. The nurse had his physical, spiritual, and emotional needs in mind.

2. Describe how Benner’s nursing theory related to Mr. Engel’s experience.

Engel was initially treated as a novice patient by all the medical professionals he interacted with. Still, as his situation became more complicated, the treatment shifted to reflect his expertise.

3. How would the care received by Mr. Engel have been improved by applying Benner’s nursing  theory?

First, it would have helped the nurses caring for Mr. Engel make better decisions and be more effective in their practice. Nurses who are more experienced and knowledgeable would provide a higher quality of care to the patient. In addition, they would also be able to provide a higher level of support and guidance to nurses who are less skilled and knowledgeable, allowing them to develop their skills faster that would otherwise be possible.