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