Ethical Consideration in Advanced Nursing Practice Essay
The presented scenario is about a 60yo man diagnosed with a history of inclusive body myositis. The client reports that his condition has been declining rapidly. The client prefers staying home with hospice relief to receiving end-of-life care. However, his wife is supporting the idea of hospitalizing him in an inpatient setting. This discussion presents the patient’s information that would be collected through assessment and diagnostic tests and evidence-based practice and ethical guidelines to consider when handling this client.
Significant Patient’s Health-Related Information
Patients’ health-related information guide clinicians in making significant decisions while diagnosing and treating patients presented with various clinical manifestations. Thus, health assessment and diagnostic tests should be conducted to collect the client’s necessary information. During health assessment, the client would be asked about the history of inclusive body myositis in his family to determine if the condition is hereditary. Secondly, the client would be asked about health-related quality of life (HRQoL) during the health assessment. According to Senn et al. (2022), this disorder leads to a relatively lower health-related quality of life (HRQoL). Thirdly, the patient’s wife would be questioned about the presence of symptoms related to mental health illnesses such as agitation, irritability, insomnia, and insomnia. In most cases, individuals diagnosed with inclusive body myositis report mental health disorders-related symptoms. Furthermore, the healthcare provider should question whether the client is currently experiencing significant symptoms of this disorder, including difficulty with gripping, buttoning, and pinching; weakness of the finger muscles and wrist; wasting of forearms’ muscle; quadriceps muscles’ weakness and visible wasting; weakness of the lower leg muscles; and esophageal muscles’ weakness. The presence of these symptoms indicates that the client’s condition is severe and requires to be hospitalized in an inpatient setting. The healthcare provider should also enquire if the client is wheelchair-bound, and how long did it take to be wheelchair-bound after being diagnosed with this disease. Additionally, a healthcare provider should conduct a physical examination during the assessment to confirm the patient’s health-related data provided by the patient or his wife. Diagnostic tests are also relevant to gathering more health-related information. Nerve conduction studies would be conducted to measure nerve signal interruptions. A creatine kinase (CK) test would also be conducted to assess the degree of CK in the body. Inclusion body myositis is characterized by a modest degree of creatine kinase (CK) elevation (Greenberg, 2019). Lastly, an electromyogram would be conducted. An abnormal electromyogram indicates an irritative myopathy with chronicity (Greenberg, 2019).
Evidence-Based Practice and Ethical Guidelines to Consider when Handling this Client
In treating this client, an advanced practice nurse should apply evidence-based practice guidelines and ethical considerations. According to Brahmer et al. (2018), individuals with terminal illnesses should be hospitalized in the palliative care unit in inpatient settings to enable healthcare providers to monitor their progress closely and provide quality health care. Thus, the 60yo patient with inclusion body myositis should be hospitalized in the palliative unit in an inpatient setting to improve his quality of life and lifespan. Additionally, the nurse practitioner should adhere to the ethical consideration of beneficence. The ethical principle of beneficence holds that healthcare professionals should aim at benefiting their patients via treatment provided to them (Varkey, 2021). Therefore, the nurse would recommend hospitalizing the client in the palliative unit in an inpatient setting to improve his quality of life, the functioning capacity, and lifespan.
Overall, information collected via health assessment and diagnostic testing would guide during diagnosis and treatment of the presented client. Additionally, an advanced practice nurse would apply evidence-based practice guidelines and ethical considerations when dealing with this client.
Brahmer, J. R., Lacchetti, C., Schneider, B. J., Atkins, M. B., Brassil, K. J., Caterino, J. M., … & Thompson, J. A. (2018). Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology Clinical Practice Guideline. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 36(17), 1714. Doi: 10.1200/JCO.2017.77.6385.
Greenberg, S. A. (2019). Inclusion body myositis: clinical features and pathogenesis. Nature Reviews Rheumatology, 15(5), 257-272.
Senn, K. C., Gumbert, L., Thiele, S., Krause, S., Walter, M. C., & Nagels, K. H. (2022). The health-related quality of life, mental health and mental illnesses of patients with inclusion body myositis (IBM): results of a mixed methods systematic review. Orphanet Journal of Rare Diseases, 17(1), 1-15. https://ojrd.biomedcentral.com/articles/10.1186/s13023-022-02382-x
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. https://doi.org/10.1159/000509119
3. 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.
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.