Category: Nursing

Describe how the theory of cultural marginality corresponds with caring in the human health experience. Provide an example from practice where you worked with a person who was living on the margins.3 scholarly citations

Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below). Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.
In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way? Does this seem like a valid process for you to apply in your practice?
Your paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.
Review the rubric for further information on how your assignment will be graded.
TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases
Medical Indications: The Principles of Beneficence and Nonmaleficence
1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?
2. What are the goals of treatment?
3. In what circumstances are medical treatments not indicated?
4. What are the probabilities of success of various treatment options?
5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
Patient Preferences: The Principle of Respect for Autonomy
1. Has the patient been informed of benefits and risks, understood this information, and given consent?
2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?
3. If mentally capable, what preferences about treatment is the patient stating?
4. If incapacitated, has the patient expressed prior preferences?
5. Who is the appropriate surrogate to make decisions for the incapacitated patient?
6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?
Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy
1. What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?
2. On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?
3. Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?
4. What ethical issues arise concerning improving or enhancing a patient’s quality of life?
5. Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?
6. What are plans and rationale to forgo life-sustaining treatment?
7. What is the legal and ethical status of suicide?
Contextual Features: The Principles of Justice and Fairness
1. Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?
2. Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?
3. What are the limits imposed on patient confidentiality by the legitimate interests of third parties?
4. Are there financial factors that create conflicts of interest in clinical decisions?
5. Are there problems of allocation of scarce health resources that might affect clinical decisions?
6. Are there religious issues that might influence clinical decisions?
7. What are the legal issues that might affect clinical decisions?
8. Are there considerations of clinical research and education that might affect clinical decisions?
9. Are there issues of public health and safety that affect clinical decisions?
10. Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?
Source: Jonsen et al., 2010

Explain principles of care for clients with oncological disorders.
ScenarioAnna is a 45-year-old female that presented to her physician’s office for her annual check-up. Anna has a history of diabetes, obesity, and noncompliance with diet and medications to control her diabetes. She a single mother of three teenagers and smokes regularly. During the history review, Anna shares with you that she has not been feeling like herself for the past six months, she has been unusually tired and thought that she felt a lump in her right breast during a self-breast exam around that same time. She stated, “I am very busy with my children; I haven’t had time to get it checked out.” She has recently been experiencing right nipple pain. Anna has a positive family history of breast cancer; both her mother and grandmother have been treated for breast cancer. Anna has never had a mammogram. During the breast examination, the practitioner palpated a lump in Anna’s right breast. No discharge from the nipple was observed. Anna’s right breast was tender upon palpation. No abnormalities were found in the left breast. Based on the physical findings Anna will undergo a diagnostic mammogram.
InstructionsIn a 2-page paper, describe the care that Anna would require and address the questions below.
What risk factors does Anna have that could predispose her to the development of cancer?
What signs and symptoms could indicate that Anna has developed cancer?
Based on Anna’s risk factors and presenting problems, identify three care strategies that you would use to provide quality care to Anna. Provide rationale to explain why you chose these strategies.

Topic: Select a major health problem that has been identified in the community for eg. substance abuse. Propose population focused interventions that may alleviate this problem.
Use APA format. Use at least three peer review articles from 2014-2020

Note: The suggested length of your response for each prompt is 2–3 paragraphs.
A. Describe three ways you can apply strategies to increase resilience and self-care that will influence your professional practice in a healthcare environment (e.g., mindfulness, better eating habits, exercise). Include specific examples.
B. Create a personal development plan by doing the following:
1. List a SMART personal growth goal for each of the three strategies from part A (for a total of three SMART goals).
Note: The SMART goals should be specific, measurable, attainable, relevant, and time-bound.
a. List one actionable step for each goal to achieve the goals for part B1, for a total of three steps.
b. Discuss how each of the goals from part B1 will foster your professional development.
C. Explain the importance of having a personal development plan.
1. Provide two examples of how a personal development plan can help you achieve your academic and career goals.
D. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
E. Demonstrate professional communication in the content and presentation of your submission.

I need one response to each peer, each one should include references, I am also including my original post Kimeh:When I originally saw that this course was about nursing theory, I was not very interested. I believed I had already learned about nursing theory in my undergraduate nursing degree and didn’t see the correlation between theory and my advanced nursing degree. As we started this course and have continued to learn throughout, I have seen not only how nursing theory will be useful in my future advanced practice role, but was able to correlate many of the theories we discussed in my current practice as a bedside nurse. In my specialty of Labor and Delivery, I see nursing practices based on nursing theory every day. Time and time again, I see that theory guides practice (McEwen & Wills, 2023). From the way we structure our orientation process to the way we comfort our patients and help them cope with the process of labor and delivering a baby, to the difficult moments during and after they sadly lose a baby, the basis of everything we do is based on nursing theories. Two examples I see used predominately are the Theory of Caring and the Theory of Comfort. I’ve seen Watson’s Theory of Caring as it promotes a healing environment for patients. Nurses are emotionally and physically present by providing support until the end of the childbirth process. Nurses encourage, motivate, build rapport, and assist patients with managing their anxiety throughout the labor process as well. All of these efforts promote healing and caring and encourage a more mother-centered care (Al-Maharma et al., 2021). The Theory of Comfort provides care from a holistic approach by implementing comfort interventions that are inclusive from physical, social, environmental, and psychospiritual aspects. The premise of this theory is for the nurse to discover what would make a patient most comfortable and provide interventions to holistically make them the most comfortable and has been shown to help reduce the pain perception of the patient during labor (Unutkan & Yangin, 2023). There are many other theories that I have seen used in current practice. I’ve learned a tremendous amount about nursing theories this term and am more inclined to incorporate more theories that will assist in my role as a Nurse Educator in the future.
References
McEwen, M., & Wills, E. M. (2023). Theoretical Basis for Nursing (6th ed.). Wolters Kluwer
Al-Maharma, D. Y., Safadi, R. R., Durham, R., Halasa, S. N., & Nassar, O. S. (2021a). Mothers’ and midwives’ and nurses’ perception of caring behaviors during childbirth: A comparative study. SAGE Open, 11(2), 215824402110245. https://doi.org/10.1177/21582440211024555
Unutkan, A., & Balci Yangın, H. (2023). Can labor support based on Kolcaba’s theory reduce the negative consequences of fear of childbirth? A pilot study. Journal of reproductive and infant psychology, 1–14. Advance online publication. https://doi-org.libauth.purdueglobal.edu/10.1080/0…
Yesenia:When I started this course, I didn’t know what to expect. I remember struggling to get through the first reading assignments, thinking I wasn’t very interested in the content. Overtime, as I learned more about different theories and how they are applied in practice, I gained more interest. I’ve learned that theory is an essential component to guiding nursing care.
While I didn’t realize it, until taking this course, theory is used in my practice environment. In the NICU, we manipulate the environment in many capacities to provide the optimal environment for our babies to grow, develop, and thrive. This practice is derived from Florence Nightingale’s environment theory. Hendy, et al., (2022) in their research found “Applying a healing environment and clustering nursing care significantly improved respiration, heart rate, oxygen saturation, and systolic blood pressure” (p. 1351). In applying Nightingale’s environment theory, we are promoting healing and improving developmental outcomes.
In the NICU, everything we do is geared toward minimizing stressors and increasing comfort. Kolcaba’s comfort theory promotes the concept of providing comfort to patients in order to decrease stressors which increases patients’ strength, resulting in, improved health outcomes. Lafond, et al., (2019) wrote “Comfort in this context is defined as a state of ease and well-being influenced by the caring and actions of nursing, which in turn leads to transcending the circumstances of symptom distress, functional status, and QOL” (p. 383). When conducting a stressful or painful procedure, we keep baby swaddled, offer sucrose, and a pacifier to minimize stress and painful stimuli. In doing so, we are comforting the patient, improving patient outcomes.
McEwen and Wills (2023) wrote “It is widely believed that use of theory offers structure and organization to nursing knowledge and provides a systemic means of collecting data to describe, explain, and predict nursing practice. I learned theory offers a framework to guide practice in addressing issues, promoting health, and providing high quality care. In my current practice, while it may not be obvious, theory is immersed in everything we do.
References
Hendy, A., Alsharkawy, S. S., & El-Nagger, N. S. (2022). The outcomes of a healing environment and clustering nursing care on premature infants’ vital signs, pain, and sleeping. Journal of Medicine and Life, 15(11), 1347–1351. https://doi.org/libauth.purdueglobal.edu/10.25122/jml-2022-0253
Lafond, D., Bowling, S., Fortkiewicz, J., Reggio, C., & Hinds, P. (2019). Integrating the comfort theory™ into pediatric primary palliative care to improve access to care. Journal of Hospice & Palliative Nursing, 21(5), 382–389. https://doi.org/10.1097/NJH.0000000000000538
McEwen, M., & Wills, E. M. (2023). Theoretical basis for nursing (6th ed.). Wolters Kluwer.
My post:At the beginning of the class, I spent most of my time questioning how abstract concepts and models in nursing could directly impact my daily practice as a nurse. However, as the course progressed, I began to realize the significance of nursing theory in guiding nursing practice and decision-making in patient care. In my current practice environment, I can see firsthand how nursing theory is integrated into patient care. With this, I have noted that understanding concepts like Maslow’s Hierarchy of Needs and the Health Promotion Model has allowed me to provide individualized patient care based on their needs. Theories guide my decision-making process and help me evaluate the effectiveness of interventions and make necessary adjustments to optimize patient outcomes. For instance, when caring for a patient with multiple chronic conditions, I applied the Theory of Chronic Sorrow to understand their emotional response to their health challenges. This theory helped me identify the patient’s feelings of grief and loss associated with their chronic illnesses. As supported in research by Nevergall(2020), the theory also allowed me to provide emotional support and coping strategies to enhance their well-being. The nursing theory has been instrumental in shaping my approach to patient-centered care. Also, the Person-Centered Care Theory, pioneered by Carl Rogers (Joseph, 2020), emphasizes the importance of understanding the patient’s unique perspective and involving them in decision-making. While nursing theory has proven valuable in my practice, I have also observed a theory-practice gap in some healthcare settings. Not all nurses may have received comprehensive education on nursing theories, leading to limited understanding and application of theoretical concepts in practice. This knowledge gap can hinder the seamless integration of theory into daily patient care, preventing nurses from fully benefiting from the potential advantages of nursing theory. Moreover, the demanding workload and time constraints in the clinical setting often leave little room for nurses to explore and apply theoretical concepts. Nurses may focus primarily on completing tasks and meeting immediate patient needs, leaving less time for reflection and incorporating theoretical perspectives into their practice. In some cases, there may be resistance to change within healthcare institutions. This resistance can prevent the adoption of new approaches, including those based on nursing theory, leading to a disconnect between theory and practice.
Healthcare institutions should prioritize ongoing education and nurse professional development programs to address the theory-practice gap. These programs should emphasize the practical applications of nursing theories and provide opportunities for nurses to reflect on their practice and integrate theoretical concepts into their decision-making process.Furthermore, fostering a supportive and encouraging environment that values critical thinking and evidence-based practice can significantly contribute to bridging the theory-practice gap. Organizational leaders should promote interdisciplinary collaboration and research initiatives, providing nurses with the necessary resources and time to explore and apply nursing theories in their practice. By addressing the theory-practice gap, we can unlock the full potential of nursing theory to enhance patient care and improve patient outcomes. Embracing nursing theory as a fundamental pillar of nursing practice can lead to more effective and compassionate care, ultimately elevating healthcare quality for all patients. References
Joseph, S. (2020). Why we need a more humanistic positive organizational scholarship: Carl Rogers’ person-centered approach as a challenge to neoliberalism. The Humanistic Psychologist, 48(3), 271.
Nevergall, T. L. (2020). A cognitive-behavioral therapy and pet-assisted therapy program for the treatment of grief and persistent grief (Doctoral dissertation, Capella University).

dentification of Short-term Goals (suggested length 1 paragraph)
Identify at least one, measurable short-term, professional goal to be completed by the end of your program.
How can an RN-BSN program help you meet your short-term goal
Identification of Long-term Goals (suggested length 1 paragraph)
Identify at least one, measurable, long-term, professional goal you want to accomplish within five years of program completion.
How can a mentor help you reach this goal?
Reflection of the BSN Role versus the ASN Role (suggested length 1-2 paragraphs)
Has your perception between the roles changed since the start of the course? Why or why not?
Support your views with a scholarly source.
Conclusion (suggested length 1 paragraph)
Summarize the key points from your paper.

A.) Scenario 1: Acute Lymphoblastic Leukemia (ALL)
An 11-year-old boy is brought to the clinic by his parents who states that the boy has not been eating and listless. The mother also notes that he has been easily bruising without trauma as he says he is too tired to go out and play. He says his bones hurt sometimes. Mother states the child has had intermittent fevers that respond to acetaminophen.
Maternal history negative for pre, intra, or post-partum problems.
PMH: Negative. Easily reached developmental milestones.
PE: reveals a thin, very pale child who has bruises on his arms and legs in no particular pattern.
LABS: CBC revealed Hemoglobin of 6.9/dl, hematocrit of 19%, and platelet count of 80,000/mm3. The CMP demonstrated a blood urea nitrogen (BUN) of 34m g/dl and creatinine of 2.9 mg/dl.
DIAGNOSIS: acute leukemia and renal failure and immediately refers the patient to the Emergency Room where a pediatric hematologist has been consulted and is waiting for the boy and his parents.
CONFIRMED Diagnosis: acute lymphoblastic leukemia (ALL) was made after extensive testing.
Questions:
1).Explain what ALL is?
2).Why does ARF occur in some patients with ALL?
Scenario B: Sickle Cell Disease (SCD)
A 15-year-old male with known sickle cell disease (SCD) present to the ER in sickle cell crisis. The patient is crying with pain and states this is the third acute episode he has had in the last 10-months. Both parents are present and appear very anxious and teary eyed. A diagnosis of acute sickle cell crisis was made.
3).Explain the pathophysiology of acute SCD crisis. Why is pain the predominate feature of acute crises?
4).Discuss the genetic basis for SCD.
Scenario C: Hemophilia
8-month infant is brought into the office due to a swollen right knee and excessive bruising. The parents have noticed bruising about a month ago but thought the bruising was due to the attempts to crawl. They became concerned when the baby woke up with a swollen knee. Infant up to date on all immunizations, has not had any medical problems since birth and has met all developmental milestones.
FH: negative for any history of bleeding disorders or other major genetic diseases.
PE: within normal limits except for obvious bruising on the extremities and right knee. Knee is swollen but no warmth appreciated. Range of motion of knee limited due to the swelling.
DIAGNOSIS: hemophilia A.
Question
5).What is the pathophysiology of Hemophilia

Pt. scenario: AC is a 72-year-old male who is admitted to your ICU after suffering a massive stroke that has left him unresponsive and unable to communicate. He is currently on a ventilator. His wife of 48 years is available along with their one adult daughter. The wife informs you that they don’t have any advanced directives, but she is “pretty sure her husband would not want to live like this.” However, their daughter is adamant her dad would want to be kept alive in case there is any chance to come out of this.
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision-making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriiptions, including strategies to minimize medication errors.

This is a discussion board post, my topic is basal cell carcinoma. All of these points need to be addressed.
-Post a picture of selected skin disorder.
-Discussion of the skin disorder, including the risk factors, transmission, signs and symptoms/characteristics/clinical manifestation.
-Discuss screening/diagnostics/treatment/management.
-Patient education.
-Role of Advanced Practice Nurse and Christian world view.