Health History and Screening of an Adolescent or Young Adult Client
February 8, 2018
Compare/Contrast · Treaties vs. Executive Agreements
February 9, 2018

Description
Mr. Miles, a 70 year old patient, was admitted to the hospital for bowel obstruction. Mr. Miles is active and
adventurous, and tells his nurse that he does not want to compromise his quality of life.
The patient becomes septic and goes into acute renal failure and must decide about dialysis and other lifesaving
measures.
The patient refuses dialysis and expresses a wish to have an advance directive do not resuscitate (DNR).
Healthcare professionals and the patient s family members express concern regarding this decision. Mr. Miles
loses consciousness before he signs a DNR.
Requirements:
Your submission must be your original work. No more than a combined total of 30% of the submission and no
more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources,
even if cited correctly.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be
used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect.
Review the scenario and write a scholarly paper in which you do the following:
A. Discuss the evidenced based practice regarding advance directive DNR.
B. Discuss the nurse s moral responsibility by doing the following:
1. Describe the nurse s responsibility to the patient in the scenario.
a. Discuss a potential moral dilemma that the nurse in the scenario may encounter. Include resolution strategies
in your response.
2. Describe the impact of the advance directive DNR on the stakeholders in the scenario.
C. Discuss how a provision from the American Nurses Association (ANA) code of ethics should relate to the
nurse s professional practice.
1. Analyze how this provision applies to the scenario.
2. Describe the importance of patient autonomy.
Note: The ANA Code of Ethics can be accessed at the web link below.
D. Discuss the legal implications associated with this case by doing the following:
1. Identify potential legal conflicts among patient, family, nurse, and organization.
2. Discuss how the potential legal conflicts identified in part D1 will affect the nursing role.
3. Discuss potential nursing actions to prevent conflicts identified in part D1 among the organization, the patient,
and primary care physician.
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E. Acknowledge sources, using APA formatted in text citations and references, for content that is quoted,
paraphrased, or summarized.

Task 1
Not Evident Approaching Competency Competent Score/Level
Articulation of Response Responses are unstructured or disjointed. Vocabulary and tone are unprofessional or distract from the topic. Responses contain pervasive errors in mechanics, usage, or grammar. Responses are poorly organized or difficult to follow. Terminology is misused or ineffective. Responses contain errors in mechanics, usage, or grammar that cause confusion. Responses are organized and focus on the main ideas presented in the assessment. Word choice is pertinent and clearly conveys the intended meaning to the audience. Responses reflect attention to detail. Mechanics, usage, and grammar promote understanding and readability.
A. Evidence-Based Practice A discussion is not provided. The discussion of evidenced-based practice is unclear or poorly reasoned. Or the discussion is irrelevant to advance directive DNR. The discussion of evidenced-based practice is clear and well-reasoned. The discussion is directly related to advance directive DNR.
B1. Moral Responsibility A description is not provided. The description of moral responsibility is accurate but generalized. Or the description is not specific to the role of the nurse in the scenario. The description of the nurse s moral responsibility is accurate and specific to the role of the nurse in the scenario.
B1a. Moral Dilemma A discussion is not provided.
The discussion of a potential moral dilemma is missing resolution strategies, or the discussion is not specific to the scenario. The discussion of a potential moral dilemma includes a conflict involving patient, nurse, family, or agency and provides logical resolution strategies. The discussion is specific to the scenario.
B2. Stakeholder Impact A description is not provided.

The description of the impact on stakeholders is not specific to advance directive DNR. Or the description does not address both patient and family. Or the description is general and not specific to the scenario. The description clearly addresses the impact of advance directive DNR on the patient and family in the scenario.
C. Discussion of Code of Ethics A discussion is not provided.
The discussion of the provision from the ANA code of ethics is generalized and not specific to the professional nursing practice. The discussion of the provision from the ANA code of ethics clearly addresses how the code should relate to the professional nursing practice.
C1. Analysis of Code of Ethics An analysis is not provided.

The analysis is unclear or illogical. Or the analysis does not directly address how the provision applies to the scenario. The analysis is clear and logical. The analysis directly addresses how the provision applies to the scenario.
C2. Importance of Patient Autonomy A description is not provided or the description lacks recognition of the patient s right to make decisions.

The description is unclear. The description of the importance of patient autonomy is missing information about patient decisions or independence. The description of the importance of patient autonomy is clear. The description accurately depicts information about patient decisions and independence.
D1. Legal Conflicts

Potential legal conflicts are not identified. The identification of potential conflicts is missing information about patient, family, nurse, or organization. The identification of potential conflicts logically addresses patient, family, nurse, and organization.
D2. Legal Implications on Nursing Role

A discussion of legal conflicts is not provided, or the discussion is lacking critical information. The discussion is missing how the conflicts affect the nursing role. Or the discussion does not address potential disciplinary actions nor potential litigation from family members. The discussion of legal conflicts includes how potential legal conflicts will impact the nursing role. The discussion addresses potential disciplinary actions and potential litigation from family members.
D3. Actions to Prevent Conflicts

A discussion of potential nursing actions to prevent legal conflicts is not provided. The discussion is missing how potential nursing actions can prevent legals conflicts specific to part D1. Or the discussion is missing conflicts that address the organization, patient, or primary care physician. The discussion of potential nursing actions logically identifies methods to prevent legal conflicts from part D1. The discussion addresses conflicts among the organization, patient, and primary care physician.
E. Sources The submission does not provide both in-text citations and a reference list for sources that are quoted, paraphrased, or summarized. The submission includes in-text citations for sources that are quoted, paraphrased, or summarized, and a reference list; however, the citations and/or reference list is incomplete or inaccurate. The submission includes in-text citations for sources that are properly quoted, paraphrased, or summarized and a reference list that accurately identifies the author, date, title, and source location as available.

 

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