EXAM 3 LECTURE

Utilitarian

the rightness or wrongness of an action depends on the consequences of the action

Feminist ethics

type of ethical approach that aims to critique existing patterns of oppression et domination in society, especially as these affect women and the poor

Social justice

upholding moral, legal, et humanistic principles

non cancerous growths of the uterus, can cause heavy bleeding between periods

uterine fibroids

Implications for justice

Always seek to distribute the benefits, risks, et costs of nursing care justly. This may involve recognizing subtle instances of bias et discrimination

Implications for beneficence

Commit yourself to actively promoting the pt's benefit Be sensitive to the fact that individuals may identify benefits et harms differently A benefit to one may be a burden to another

Examples of virtues

Competence Compassionate caring Subordination of self-interest to pt interest Self-effacement Trustworthiness Conscientiousness Intelligence Practical wisdom Humility Courage Integrity

Characteristics of the care-based approach perspective

-centrality of the caring relationship -promotion of the dignity et respect of pts as ppl -attention to the particulars of the individual pt -cultivation of responsiveness to others et professional responsibility -a redefinition of fundamental moral skills to include virtues like kindness, attentiveness, empathy, compassion, reliability

ANA Code of Ethics for Nurses purposes

-it is a succinct statement of the ethical obligations et duties of every person who enters the nursing profession -it is the profession's nonnegotiable ethical standard -it is a expression of nursing's own understanding of its commitment to society

Principle-base approach to ethics (Beauchamp et Childress)

Combines elements of both utilitarian et deontologic theories et offers specific actions guided for practice

Seven basic tenets of the Bill of Rights for RNs

1. Right to practice in a manner that fulfills their obligations to society et those that receive nursing care 2. Right to practice in environments that allow them to act in accordance c professional standards et legally authorized scopes of practice 3. Right to a work environment that supports et facilitates ethical practice 4. Right to freely et openly advocate for themselves et their pts, s fear of retribution 5. Right to fair compensation for their work, consistent c their knowledge, experience, et professional responsibilities 6. Right to work in an environment that is safe for themselves et their pts 7. Right to negotiate the conditions of their employment

cycles are ______________ days long, but varies 21-40 days

28

normal bleeding during menstruation is _____________ day

3-7

normal blood loss during your period is ______________

30-80 mL

____________ of women experience at least 1 PMS symptom _______________ of women present with premenstrual disorder

85% 12%

Altruism

A concern for the welfare et well-being of others

Ethics

A systematic study of principles of right et wrong conduct, virtue, et vice, et good et evil as they relate to conduct et human flourishing

What is an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct?

A value system

-HIV -positive ELISA and western blot tests -incidince high in IV drug users, and gay and bisexual men -fatigue, diarrhea, weight loss, enlarged lymph nodes, anorexia and night sweats

AIDS

-primary and secondary sex characteristics develop -sexual fantasies common -masturbation common -at risk for pregnancy and STI's -gender identification often solidified -parents share belif and values -teens may share feelings with parents -teens need info regarding contraceptives

Adolescence (13-19yo)

-body changes-menopause -couples focus on quality over quantity -divorce is common -sexual satisfaction increases because loss of fear of pregnancy -men and women need positive reinforcement of what is good about themselves in their relationship -empty nest syndrome common -renewal period for relationships

Adulthood (35-55yo)

Examples of altruism

Advocating for pts et taking risks on behalf of pts et colleagues

ethical delimma

Arise when attempted adherence to basic ethical principles results in two conflicting courses of action

What is planning care in partnership c pts an example of?

Autonomy

Four key principles of principle-based approach

Autonomy, nonmaleficence, beneficence, et justice Additional ones: fidelity, veracity, accountability, privacy, et confidentiality -these play a central role in the tradition of nursing ethics

Nonmaleficence's moral rule

Avoid causing harm

-imbalance of bacteria, alters flora in the vagina -symptoms in women: foul smelling, thin, grayish white vaginal discharge -men usually asymptomatic

Bacterial Vaginosis (BV)

Implications for fidelity

Be faithful to the promise you made to the public to be competent et t9 be willing to use your competence to benefit the pts entrusted to your care. Never abandon a pt entrusted to your care first providing for the pt's needs

Values

Beliefs about the worth of something, about what matters, that act as a standard to guide one's behavior

Beneficence's moral rule

Benefit the pt, et balance benefits against risks et harms

When does ethics begin?

Childhood

-intracellular bacteria -primarily affects people ages 15-24 yo -many people asymptomatic -symptoms in women: vaginal discharge, burning or urination, urinary frequency, dysuria, and uretheral soreness -symptoms in men: penile discharge, burning sensation with urination, pain and swelling in testicles

Chlamydia

Three Main Activities of the Valuing Process

Choosing, Prizing (treasuring), et Acting

Developing moral resilence

Cultivating good relationships Accepting that change is a part of living Refusing to view crises as insurmountable Nurturing a positive view of self et taking care of self Keeping things in perspective

-menses/menstrual flow lasts 3-7 days with flow averaging for 5 days -menstrual debris contains endometrial debris, mucus, and enzymes--normal blood loss is 30-80 mL -the flow is the heaviest and bright red on the first day or two of menses, gradually tapering off the light brown staining -deodorized pads and tampons can cause chemical irritation to the vulva and vagina

Day 28

moral resilience

Developed capacity to respond well to morally distressing experiences et to emerge strong

Four functions of ethics committees

Education Policy making Case review Consultation Occasionally research

procedures that intentionally injure or alter the female genital organs for nonmedical reasons -can cause severe problems urinating -can cause cysts, infections, and infertility as well as complications in childbirth and increased risk of newborn deaths

FGM (female genital mutilation)

Justice's moral rule

Give each his or her due; act fairly

Virtues

Human excellences, cultivated dispositions of character et conduct that motivate et enable us to be good human beings

-needs affection and tactile stimulation -boys have penial erections, girls have orgasmic potential -avoid early weaning -self-manipulation of genitals is normal

Infancy (birth-18mo)

- a DSM5 classified diagnosis -symptoms primarily psychiatric - related to serotonin levels

PMDD (premenstrual dysphoric disorder)

Fidelity's moral code

Keep promises

-orgasms become shorter and less intense -vaginal secretions decrease period of resolution lengthens in men -fear of loss of sexual abilities -teach adaptation to bodily changes -teach alternatives to coitus

Late Adulthood (55-older)

-follicle fills up with yellow pigment and is called the corpus luteum or yellow body -uterus undergoes secretory phase, the endometrial lining thickens

Luteal Phase (day 15-28)

Is a person born c values?

No, they are formed during a lifetime involving influences from the environment, family et culture

Care-based approach

Nurse-pt relationship is central

hormonal disorder that can cause small cysts to develop on the ovaries and irregular menstration

PCOS (polycystic ovary syndrome)

Examples of ethical problems

Paternalism - acting s pt consent Deception Privacy et social media Confidentiality Allocation of scarce nursing resources Valid consent or refusal Conflict concerning new technologies Unprofessional, incompetent, unethical, or illegal physician or nurse practice Short staffing issues Beginning-of-life issues End-of-life issues

-puberty usually begins -menarche takes place -may test behavioral limits -give info about puberty -rules shouldnt be too lax or too strict -treat body changes with positive attitude

Preadolescence (10-13yo)

-increasingly aware of self -enjoys body parts of self and playmates -engages in masturbation -gender identity is formed -parents cause anxiety due to intolerance of sex-role behavior -negative overreaction of parents about masturbation leads to guilt

Preschooler (4-6yo)

Advocacy in nursing practice

Primary commitment to pt Prioritization of good of individual pt rather than society in general Evaluation of competing claims of pt's autonomy et pt well-being

Values clarification

Process by which ppl come to understand their own values et value system

What do nurses committed to high-quality care base their practice on?

Professional standards of ethics,conduct as well as professional values

Advocacy

Protection et support of another's rights

Implications for autonomy

Provide info et support pts et families need to make the decision that is right for them, including collaborating c other members of the health care team to advocate for the pt

Example of integrity

Providing honest info to pts et the public

Morals

Refers to personal or communal standards of right et wrong

Conscientious objection

Refusal to participate in certain types of tx et care based on the fact that these activities violate the nurse's personal et professional ethical beliefs et standards

Areas of concern for pt advocates

Representing pts Promoting self-determination Whistle-blowing Being politically active

Human dignity

Respect for the inherent worth et uniqueness of individuals et populations

Autonomy aka self-determination's moral rule

Respect the rights of pts or their surrogates to make healthcare decisions

Implications for nonmaleficence

Seek not to inflict harm; seek to prevent harm or risk of harm whenever possible

What is supporting fairness et nondiscrimination in the delivery of care an example of?

Social justice

1. excitement 2. plateau 3. orgasm 4. resolution

sexual response cycle

Autonomy

The right to self-determination

-establishes control over bowel and bladder -both sexes enjoy touching genitals -able to identify their genitals -allow them to determine their readiness for toilet training -punishment for foundling leads to guilt

Toddler (1-3yo)

-premarital sex common -sex increases pleasure of relationship -own value system -share financial responsibility with partner -encourage communication between partners about sexual needs and differences -prevent unwanted pregnancies

Young Adulthood (20-35yo)

Bioethics

a number of fields et disciplines grouped broadly under the rubric "the life sciences"

Code of ethics

a set of principles that reflect the primary goals, values, et obligations of the profession

Nursing ethics

a subset of bioethics; formal study of ethical issues that arise in the practice of nursing et of the analysis used by nurses to make ethical judgments

Integrity

acting in accordance c an appropriate code of ethics et accepted standards of practice

-between 2 consenting adults -mutually satisfy to both -not harmful mentally and physically -lacking in force or coercion

adaptive

Professional values

altruism, autonomy, human dignity, integrity, social justice

Deontologic

an action is right or wrong based on a rule, independent of its consequences

the most important organ for sexual arousal is the _____________

brain

partial/total removal of the clitoris

clitoridectomy

produces hormones that encourages the fertilized egg to grow

corpus luteum

abd cramping during menses

dysmenorrhea

areas that when stimulated, cause sexual arousal and desire -skin is the largest zone -ears, lips, thighs, breasts

erogenous zones

partial/total removal of clitoris and labia minora

excision

-initiated by erotic stimulation and arousal -increase HR and BP -congestion of genitals with blood flow begins in this phase -women usually have a prolonged period of stimulation than do men

excitement phase

-follicles mature -only one produces mature ovum

follicular phase (day 4-14)

narrowing of vaginal opening thru the creation of covering seal formed by cutting/repositioning of inner, outer labia with or without the removal of clitoris

infibulation

-sexual responses that do not meet one or more of the criteria for adaptive

maladaptive

gaining sexual pleasure from the humiliation of being abused

masochism

-first period -usually around 12 yo -can occur between 8-17 yo

menarche

cessation of women's menstrual activity -45-55 yo

menopause

-pregnancy and breast feeding -eating disorders, extreme weight loss, excessive exercising -polycystic ovary syndrome -prematue ovarian failure -pelvic inflammatory disease -uterine fibroids

menstrual irregularities causes

the climax and sexual explosion of built up tension from previous phases -lasts only seconds, extremely intense

orgasm

During menstruation, there are 2 cycles going on simultaneously. one in the ___________________ and one in the _________________

ovaries, endometrium

-mature ovum ruptures from the follicle and surface of the ovary and swept into the fallopian tube -if sperm present, fertilization occurs now

ovulation (day 14)

intensity greater than excitement phase, not enough for orgasm -desire and arousal intensifies -varies from a few min to 15-20 min

plateau

loss of ovary function before 40yo, may have irregular, infrequent periods for years

premature ovarian failure

-endometrium becoming thick and velvety in prep for receiving a fertilized egg

proliferation phase (day 4-14)

return to normal body functioning present before the exitement phase -men experience refactory period

resolution

practice of gaining sexual pleasure while inflicting abuse on another person

sadism

sadism and masochism, tied up, hitting, spanking, etc

sadomachism

romantic, emotional, affectionate, or sexual attraction to other people

sexual orientation

achievement of sexual arousal by looking at the body of someone other than ones sexual partners

voyeurism