Select One Scenario And Reflect On The Material Presented

Select one scenario and reflect on the material presented throughout this course

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. pick one out of the scenario and write on: Please follow assignment instructions and you may pick one of the following ethical case studies: CASE STUDY 1 The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines. CASE STUDY 2 A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance. CASE STUDY 3 A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment CASE STUDY 4 A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled. CASE STUDY 5 A 17-year-old boy has come in for a check-up after a head injury during a football game. He has indicated that he would like to be able to play in the next game, which is in 3 days. CASE STUDY 6 A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity. CASE STUDY 7 A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient unit at a hospice to receive end-of-life care, but his wife wants him to remain at home. Rubric: Write a detailed 1-page narrative (not a formal paper) addressing the following: · Explain 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. Written Expression and Formatting - Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused--neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. Written Expression and Formatting - English writing standards: Correct grammar, mechanics, and proper punctuation Written Expression and Formatting - The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.

Paper For Above instruction

The scenario selected for this reflective narrative is Case Study 4, involving a single mother who has accompanied her two daughters, aged 15 and 13, to a women’s health clinic requesting pelvic examinations and initiation of birth control. This case presents complex clinical and ethical considerations, including the assessment of the adolescents' health needs, ethical principles such as autonomy, beneficence, and confidentiality, and adherence to evidence-based practice guidelines. As an advanced practice registered nurse (APRN), providing comprehensive, sensitive, and ethically sound care requires a thorough understanding of the necessary health assessment information, appropriate clinical decision-making, and navigation of ethical and legal considerations.

Health Assessment Information for Diagnosis and Care Planning

Effective health assessment begins with a detailed history and physical examination, tailored to address the specific needs of adolescent patients in reproductive health. Essential information includes the girls’ menstrual histories, sexual activity status, previous contraceptive use, sexual health education, screening for sexually transmitted infections (STIs), and psychological readiness and understanding of contraception. Additionally, assessing risk factors such as exposure to coercion, abuse, or peer pressure is vital. Laboratory assessments may include STI screenings, pregnancy testing, and evaluation of contra-indications for various contraceptive methods, such as blood pressure measurement before initiating hormonal contraception. A comprehensive review of medical history, including past gynecologic issues or contraindications, is also needed.

Responding as an Advanced Practice Nurse: Evidence-Based Practices and Ethical Considerations

In responding to this scenario, I would prioritize establishing a trusting, respectful relationship with the adolescents and their mother, emphasizing confidentiality while clarifying the boundaries of legal and ethical obligations. According to the American College of Obstetricians and Gynecologists (ACOG, 2017), adolescents have the right to consent to reproductive health services without parental involvement, provided they are deemed capable of understanding the nature and consequences of care. Ethical principles such as respect for autonomy support respecting the girls' confidentiality and decision-making capacity.

Adopting a nonjudgmental attitude and providing age-appropriate education about reproductive health, contraception options, and STI prevention aligns with the framework outlined in the Society for Adolescent Health and Medicine (SAHM, 2018). These practices uphold beneficence by promoting the girls’ health and well-being and ensure justice by providing equitable access to healthcare services despite the family's religious beliefs. Engaging in motivational interviewing techniques can help assess their readiness and support informed choices while addressing any concerns or fears.

Application of Evidence-Based Guidelines

The CDC’s guidelines recommend routine screening for STIs in sexually active adolescents, including chlamydia and gonorrhea, and consider initiating long-acting reversible contraceptives such as IUDs or implants based on individual preferences and medical suitability (CDC, 2020). These methods have proven high efficacy and safety profiles for this age group (Creinin et al., 2017). It is essential to individualize care, respecting the preferences of the adolescents, and providing counseling on correct and consistent contraceptive use.

From an ethical perspective, autonomy and confidentiality are paramount, but the clinician must also navigate laws that vary by jurisdiction regarding minors’ consent. In most states, adolescents can consent to contraceptive services without parental approval, aligning with the legal framework and ethical standards that promote access to preventative health care (Higgins et al., 2018). Clear documentation of the encounter, respecting confidentiality, and ensuring the adolescents understand their rights are essential components of ethical practice.

Conclusion

The comprehensive health assessment in adolescent reproductive health involves gathering detailed medical, sexual, and psychosocial histories alongside targeted physical assessments and lab testing. As an APRN, responding ethically requires balancing respect for minors’ autonomy with legal mandates and providing evidence-based, adolescent-friendly care. Ethical principles like confidentiality, beneficence, respect, and justice must guide practice, supported by current clinical guidelines and research evidence. Through sensitive communication, thorough assessments, and adherence to ethical and legal standards, optimal health outcomes can be achieved for adolescent patients.

References

  • American College of Obstetricians and Gynecologists (ACOG). (2017). Committee opinion no. 707: Providing counseling to adolescent patients. Obstetrics & Gynecology, 130(4), e165-e168.
  • Centers for Disease Control and Prevention (CDC). (2020). STD Treatment Guidelines. https://www.cdc.gov/std/tg2020/default.htm
  • Creinin, M. D., Simonsen, R., et al. (2017). Contraceptive efficacy and safety of intrauterine devices and contraceptive implants among adolescents: A systematic review. Contraception, 95(6), 629–637.
  • Higgins, J. A., et al. (2018). Adolescents’ rights to confidential reproductive health services: Considerations for clinicians and policymakers. Journal of Adolescent Health, 62(1), 2–8.
  • Society for Adolescent Health and Medicine (SAHM). (2018). Reproductive health care for adolescents and young adults. Journal of Adolescent Health, 62(4), e79-e111.
  • World Health Organization (WHO). (2018). Improving adolescent health: The importance of vaccination and preventive care. Geneva: WHO Publications.
  • American Academy of Pediatrics (AAP). (2017). Policy statement on providing contraceptive services to adolescents. Pediatrics, 139(2), e20163336.
  • Guttmacher Institute. (2021). Contraceptive use among U.S. adolescents. https://www.guttmacher.org/fact-sheet/contraceptive-use-us-adolescents
  • Holmes, K., et al. (2019). Ethical considerations in adolescent reproductive health care. Journal of Medical Ethics, 45(3), 182–185.
  • Mitchell, K. R., et al. (2020). Legal and ethical aspects of adolescent access to reproductive health services. Journal of Law, Medicine & Ethics, 48(3), 351–359.

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