Question

Please use APA format and references please

Ethical Reasoning Assignment

You will use your analysis of the case study as a foundation for an ethical discussion. This discussion will provide you an opportunity to apply ethical reasoning to an ethical issue within the field of pediatric nursing: The use of growth hormones. You will also have an opportunity to demonstrate your writing skills. Your assignment should include a title and a reference page. Your assignment should be double spaced using a 12 point, Times New Roman font. Your viewpoint and purpose should be clearly established and sustained. Your assignment should follow the conventions of Standard English which includes correct grammar, punctuation, and spelling. Your writing should be well ordered, logical and unified, as well as original and insightful. Any citations should follow APA 6th edition formatting. For more information on these guidelines please visit the Purdue University Global Writing Center.

Case Study:

Sean is a 6-year-old Caucasian male that presents to your pediatric clinic for a well-child visit. His measurements are as follows: Height = 40 inches; weight = 35 lbs. Sean’s vision was assessed and found to be 20/20; his hearing was assessed as passing down to 20 decibels. Sean is in the 1st grade and earning A and B grades. No behavior problems have been reported in school. He lives in a single family home with his mother, father, 3-year-old sister, 14-year-old sister, and the family dog. He frequently visits his grandmother, who is a smoker.

Sean’s mother reports that he is very active but can sustain attention for long periods with video games. He can also pay attention and stay on task with schoolwork and homework. He follows a routine at home but does not become very upset if it is not followed. She reports that he is slow to adapt to new things but will eventually settle in without much difficulty. He can be moody several times a week but this is a small part of his overall personality. Sean participates in a recreational soccer league for 12 weeks in the fall and in a recreational basketball league for 8 weeks in the winter. He also attends Sunday school each week and is in the cub scouts. Sean’s past medical history includes pyloric stenosis, tonsillitis x3, mild intermittent asthma that began at age 3 years, and short stature. He does not take any regular medications but the family is considering the possibility of evaluating him for growth hormone to make him taller. Sean does not want to have any painful procedures at this time.

Sean’s family medical history includes:

a.    Mother: Age 35, Ht. 5 ft. 1 inch, Wt. 125 pounds, Celiac disease; precocious puberty; inflammatory bowel disease

b.    Father: Age 38, Ht. 5 ft. 6 in., Wt. 166 pounds, Lactose intolerance; B-Thalassemia; Addison’s disease

c.    Maternal grandmother: Hypertension; hyperlipidemia; bacterial endocarditis

d.    Maternal grandfather: Hypopituitarism

e.    Paternal grandfather and grandmother: Unknown

Answer the following questions as you develop your paper. Your responses should demonstrate a sustained point of view and allow for a continuous piece of writing:

1.    There are four main principles with medical ethics: Beneficence, autonomy, non-maleficence, and justice. What is the definition of each ethical principle? Give an example of each.

2.    Physical parameters: Take Sean’s height and weight and plot them on a growth curve. Report his percentiles for both height and weight. Calculate BMI. Analyze and describe Sean’s proportions regarding whether he is over, under, or average weight and height compared to the norm for children his age.

3. What evidence (case study and above parameters) is there to support whether Sean’s condition is medical or hereditary? Is the decision to administer or not to administer growth hormone dependent upon whether a child’s condition is medical or hereditary? Use the above principles of ethics to justify your opinion using ethical principles

4. What are the physical benefits and risks of administering growth hormone? What are the psychosocial benefits and risks of administering growth hormone? Are there any burdens (cost, time) with regard to administering growth hormone? Do the benefits outweigh the risks? Justify your answer using ethical principles

5. What are Sean’s rights as a minor in the United States? At what age can Sean successfully make his own choices? How can you deal with ethical rights without infringing on the legal rights of the parents?

6. Use what you learned about medical ethics to support or discourage the use of growth hormones for Sean. Justify your answer using medical ethics.

NCLEX Questions Review Assignment Unit 7

You must complete 25 review questions on pediatric cardiovascular. You can take the quiz as many times as you would like and turn the highest score into the assignment dropbox

1. Log onto your Evolve account.

2. Log onto Evolve Resources for Saunders Comprehensive Review for the NCLEX-RN Examination.

3. Click on Resources.

4. Click on Exam Review.

5. On the next screen (Step 1), go under the heading Exam and pick 25 questions.

6. Step 2, choose content.

7. Step 3, choose Child Health, Cardiovascular.

8. Begin exam.

9. After completion, click on end tally results.

10. It will take you to a screen that lists your history of exams taken.

11. Click on the last exam taken and it will show you a breakdown of the exam.

12. Save this on your computer and turn it in the assignment drop box.

Answer 1

1. Ideally, for a medical practice to be considered "ethical", The medical professionals must respect all four of these principles: autonomy, justice, beneficence, and non-maleficence.

a. Autonomy

According to this principle, the patient has autonomy of thought, intention, and action when making decisions regarding health care procedures. Therefore, the decision-making process must be free of coercion. In order for a patient to make a fully informed decision, she/he must understand all the risks and benefits of the procedure and the likelihood of success. Freedom of choice by the patient.

Eg: Getting the consent of the patient before surgery.

b. Justice

The idea that the burdens and benefits of new or experimental treatments must be distributed equally among all groups in society. Requires that procedures uphold the spirit of existing laws and are fair to all players involved. The health care provider must consider four main areas when evaluating justice: fair distribution of scarce resources, competing needs, rights and obligations, and potential conflicts with established legislation.

Eg: Reproductive technologies create ethical dilemmas because treatment is not equally available to all people.

c. Beneficence

Requires that the procedure is provided with the intent of doing good for the patient involved. Demands that health care providers develop and maintain skills and knowledge, continually update training, consider individual circumstances of all patients, and strive for net benefit.

Eg; The dietician will create a diet plan for the child according to the present nutrition pattern giving more consideration to the malnourished area.

d.Non-maleficence

Requires that a procedure does not harm the patient involved or others in society.

Eg: Infertility specialists operate under the assumption that they are doing no harm or at least minimizing harm by pursuing the greater good. However, because assistive reproductive technologies have limited success rates uncertain overall outcomes, the emotional state of the patient may be impacted negatively. In some cases, it is difficult for doctors to successfully apply the do no harm principle.

2. Here Sean's height is 40 inches and weight is 35 Ibs. Thus we can calculate his Body Mass Index as 15.4. This is considered severely underweight.

3.  Here in the present scenario, the Seans condition is hereditary,

why because of his mother is having the height: 5 ft. 1 inch, Wt. 125 pounds,

Father height is 5 ft. 6 in, Wt. 166 pounds

Here the decision regarding the administration of growth hormone is mainly based on the child's medical condition. Normally the growth hormone is administered for GH deficiency, chronic kidney disease, Turner syndrome, small-for-gestational-age with failure to catch up to the normal height percentiles, Prader-Willi syndrome, idiopathic short stature, SHOX gene haploinsufficiency, and Noonan syndrome. Here we can see its a hereditary condition, explain regarding that to the parents and better to avoid the administration of growth hormones unnecessarily to avoid future complications.

Here we can apply the principle of non-maleficence where we do not harm the patient.

The principle of autonomy: after explaining the indications and its effects we have to give freedom of choice for the patient and family members.

4. The growth hormone helps to restore energy, metabolism, and enhance body development or shape. It can help to reduce total body fat, especially around the belly. Growth hormones injections can also help to improve strength and exercise tolerance and reduce the risk of heart disease in those who lack growth hormone.

The risks for the growth hormone injections are :

• muscle aches
• joint discomfort
• headaches
• swelling of the hands and feet
• Chance of scoliosis

Treatment for growth hormones injections, typically administered daily until the child reaches adult height. Growth hormone deficiency treatment burden and convenience can be important aspects for treatment adherence because the therapeutic benefits of the GH treatment are not immediate, and treatment or adherence may be compromised by low motivation.

Few studies have been conducted that assess burdens specific to growth hormone treatment; however, the available literature suggests that GHD treatment can be difficult to manage because of refrigeration and storage burdens, an inconvenience when reconstitution is necessary, and managing overnight travel (a major contributor to missed doses). These burdens are in addition to the pain caused by the injections themselves.

Here we can apply the principle of autonomy to choose for the treatment. The patient and the parents have to decide they have to go forward after knowing the benefits and risks of the treatment.

5. Sean’s rights as a minor in the United States as he has to obey the decisions taken by his parents especially in taking medical decisions. At the age of 16 Sean successfully make his own choices.

When multiple professionals are giving different options for treatment, parents have a right to choose which is best for their child. If the child's parents are not acting in the best interest of their welfare, the state or organization policy can override parental decisions.

6. Here in the present case, the patient is minor and unable to make decisions and the parents have to make decisions. Here in the case of Sean after taking the growth hormone treatment there may be a chance of getting risks more than benefits. Here according to medical ethics, we have to follow the principle of medical ethics Principle of non-maleficence.