Respiratory Care of Patients With Neuromuscular Disease Discussion

Ethical principles and legal measures are applied in various areas of clinical practice. Specifically, clinicians consider ethical principles of non-maleficence and patient autonomy when making decisions for patients at the end-of-life stage. Studies show that engaging family in making decisions and treatment of critically-ill patients results in positive health outcomes (Kydonaki et al., 2021). For this reason, nurse practitioners should consider the family’s decision concerning patient’s treatment in the end-of-life care to earn their support. This paper analyzes potential implications and disclosure and non-disclosure approaches in medication error involving a 72yo male, A.C admitted to the ICU with a massive stroke. Respiratory Care of Patients With Neuromuscular Disease Discussion

Ethical and Legal Implications in the Context of the Case Study

The nursing professional standards require nurses to prioritize their patients by providing them with high-quality and safe care. NPs also have legal and ethical obligations to protect their patients from potential and preventable harm and respect their decision concerning their treatment (Schiller et al., 2019). In this case, the family makes decision concerning the patient’s treatment since he does not have end-of-life care directives. The prescriber’s action significantly depends on the family’s decision. Therefore, the prescriber has not acted against ethical or legal guidelines. Moreover, ethical implications are not applicable to the pharmacist since he puts the patient in a ventilator to save his life and prevent potential respiratory distress; hence, adhering to the principles of beneficence and non-maleficence (Akbar & Hernoko, 2022). Additionally, the daughter does not violate any ethical principle since she supports her dad’s wish to protect his life. However, the patient’s wife violates the principle of non-maleficence since her decision would eventually terminate the patient’s life if the ventilator was withdrawn.

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Error Disclosure and Non-Disclosure Interventions

The Nursing Practice Act (NPA) in the state of practice advocates for the disclosure of all medication errors. NPs must discuss potential outcomes of a particular treatment therapy with the patient or the family. The family must be informed about adverse health outcomes associated with a specific treatment therapy. In this case, the nurse practitioner should inform the patient’s family that removing the patient from the ventilator would eventually interfere with his breathing, resulting in respiratory distress (Benditt, 2019). Respiratory Care of Patients With Neuromuscular Disease Discussion

Making Decisions Regarding Disclosure in the Scenario

NPs’ actions are guided by morality, integrity, and a code of ethics. The ethical principle of beneficence is considered a rule of law that holds that clinicians have a moral obligation to benefit others through their actions (Varkey, 2021). In this scenario, I would disclose the error to the patient’s caregivers for appropriate actions to be taken to avoid causing harm to the recipient or others. For instance, reporting the error would result in appropriate medical action particularly retaining the patient in the ventilator, reducing the risk of potential health complications, such as respiratory distress.

Process of Writing Prescriptions

Extra care is needed when writing prescriptions to prevent AE. The NP must assess the pinpoint issue before prescribing to ensure a particular medication is effective in managing the patient’s health issue (Choukroun et al., 2021). Furthermore, the patient’s pharmacokinetics and pharmacodynamics must be considered to prevent potential adverse reactions or serum toxicity in geriatrics (American Geriatrics Society, 2023). Moreover, they should inform the patient about potential adverse drug reactions with a particular medication or substance, such as alcohol. The clinician also counter-checks the prescription to ensure the properties of the medication, including dose, frequency, administration route, and storage, are correct. Lastly, the provider informs the patient about potential severe side effects that would require the patient to contact the provider. Respiratory Care of Patients With Neuromuscular Disease Discussion

References

Akbar, S. A., & Hernoko, A. Y. (2022). Ethical-Medicolegal Aspects of Installation and Removal of Ventilator in Life Support Efforts for Critical Patients during Covid-19 Pandemic. Verdict: Journal of Law Science, 1(1), 1-15.

American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society.

Benditt, J. O. (2019). Respiratory care of patients with neuromuscular disease. Respiratory Care, 64(6), 679-688.

Choukroun, C., Leguelinel-Blache, G., Roux-Marson, C., Jamet, C., Martin-Allier, A., Kinowski, J. M., … & Antoine, V. (2021). Impact of a pharmacist and geriatrician medication review on drug-related problems in older outpatients with cancer. Journal of Geriatric Oncology, 12(1), 57-63.

Kydonaki, K., Kean, S., & Tocher, J. (2020). Family INvolvement in inTensive care: A qualitative exploration of critically ill patients, their families and critical care nurses (INpuT study). Journal of Clinical Nursing, 29(7-8), 1115-1128.

Schiller, C. J., Pesut, B., Roussel, J., & Greig, M. (2019). But it’s legal, isn’t it? Law and ethics in nursing practice related to medical assistance in dying. Nursing Philosophy, 20(4), e12277.

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28.

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient? Respiratory Care of Patients With Neuromuscular Disease Discussion

These are some of the questions you might consider when selecting a treatment plan for a patient.

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond. Respiratory Care of Patients With Neuromuscular Disease Discussion

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

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WEEKLY RESOURCES

To Prepare:

Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
Review the scenario assigned by your Instructor for this Assignment.
Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors. Respiratory Care of Patients With Neuromuscular Disease Discussion
BY DAY 7 OF WEEK 1
Write a 2- to 3-page paper that addresses the following:

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 prescriptions, including strategies to minimize medication errors. Respiratory Care of Patients With Neuromuscular Disease Discussion