NURS 6512 Assignment Ethical Concerns

NURS 6512 Assignment Ethical Concerns

NURS 6512 Assignment Ethical Concerns

The case study concerns a 17-year-old girl accompanied by her father to a women’s health clinic. The father requests that the daughter have a pregnancy test, but the girl fails to consent and appears uneasy. The health assessment information needed to diagnose pregnancy includes the patient’s menstrual history. The clinician should ask the girl about her typical menstrual pattern, the date of onset of last menses, flow, duration, and frequency (Bastian & Brown, 2020). In addition, the clinician should obtain information on the presence of the classic features of pregnancy, including amenorrhea, generalized malaise, nausea, vomiting, and breast tenderness. Information on sexual history is crucial in suspected pregnancy cases.

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Physical exam findings that may help diagnose pregnancy include breast changes, a positive enlarged uterus on bimanual examination, and softening and enlargement of the cervix around the sixth week. Besides, a positive Chadwick sign, a bluish discoloration of the cervix due to venous congestion, can point to pregnancy and is often observed by 8-10 weeks (Pascual & Langaker, 2022). A gravid uterus can be palpable low in the abdomen if the pregnancy has advanced enough, usually by the 12th week.

A dilemma transpires when a parent insists that some assessment or test be conducted against a minor’s wish. It is ethically documented that a healthcare provider should not do anything that risks harming a patient. In this case, I would follow the basic rule that my patient is the child, not the father. Consequently, I would have a conversation with the girl to discuss her sexual history and assure her that the information would be confidential. The APN can face liability risks if they perform the pregnancy test despite the minor refusing. Testing the minor against her will can contribute to mental and psychological damage, and the parent can file a claim if they unexpectedly change their mind (Larcher & Brierley, 2018). Therefore, I would counsel the girl and ask for consent to conduct the test. If she refuses, I would accept her wishes and inform the father that we cannot force the test and that the minor’s medical records are confidential for encounters concerning reproductive health.

References

Bastian, L. A., & Brown, H. L. (2020). Clinical manifestations and diagnosis of early pregnancy. Waltham, MA: UpToDate.

Larcher, V., & Brierley, J. (2018). Developing guidance for pregnancy testing of adolescents participating in research: ethical, legal and practical considerations. Archives of Disease in Childhood, 101(10), 980–983. https://doi.org/10.1136/archdischild-2018-310725

Pascual, Z. N., & Langaker, M. D. (2022). Physiology, pregnancy. In StatPearls [Internet]. StatPearls Publishing

Scenario: A single father has accompanied his 17 year old daughter to a women’s health clinic and has requested that the his daughter has a pregnancy test. The girl has not consented to the test and seems uneasy.
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.