NUR 112 Chapter 6 Values, Ethics, Advocacy
A client aged 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. The nurse communicates the client's wish to the family and healthcare team. This is an example of what ethical principle?
autonomy- "right to self-determination"
What is the term for the beliefs held by the individual about what matters?
values-"belief about the worth of something, about what matters, that acts as a standard to guide one's behavior"
virtues of nurses
- Competence - Conscientiousness - Compassionate caring - Intelligence - Subordination of self-interest to patient care - Practical wisdom - Humility - Self-effacement - Courage - Trustworthiness - Integrity
A client is scheduled to have an elective surgical procedure performed but cannot decide whether to go forward with the procedure or cancel it. The client asks the nurse to help make the decision because the client lacks knowledge about the procedure. Which action by the nurse is the best way for this nurse to advocate for the client?
Allow the client to verbalize feelings, and provide information to help the client assess options.
Which scenario is an example of the laissez-faire approach to value transmission?
Allowing a child to decide not to have an intravenous line inserted
A client who has delivered a baby by Cesarean section rates pain as a 9. The nurse medicates the client for pain. This is an example of the nurse practicing which ethical principle?
Beneficence
A nurse working on a critical care unit was informed by a client with multiple sclerosis that the client did not wish to be resuscitated in the event of cardiac arrest. Now the client is no longer able to express wishes, and the family has informed the physician that they want the client to be resuscitated. Aware of the client's wishes, the nurse is involved in a situation that may involve:
Ethical distress- occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action.
A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics?
Fidelity
International Council of Nurses Code of ethics
Nurses and : people, practice, profession, co-workers
Which is a characteristic of the care-based approach to bioethics?
The promotion of the dignity and respect of clients as people
Nurses who value client advocacy follow what guideline?
They give priority to the good of the individual client rather than to the good of society in general.
Two theories of ethics
Utilitarian, deontologic
altruism
a concern for others; generosity
A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee?
assist in decision making based on the client's best interest
Which word is best described as protection and support of another's rights?
advocacy
A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing the nurse's own judgments based on the nurse's expertise. Which type of healthcare decision making does this represent?
shared decision making
Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?
care-based ethics
Which traits are examples of virtues that can exemplify character and conduct as a professional nurse?
competence, compassion, trustworthiness, humility, integrity
Allowing a child to decide not to have an intravenous line inserted
tell me more about your culture beliefs
Name some commonly encountered nursing ethical issues.
end of life decisions, DNR, no codes, breach confidentiality, illegal practice colleague
Utilitarian Approach
ethical philosophy that advocates a decision that provides the most good or the least harm
deontologic
ethical system in which actions are right or wrong independent of the consequences they produce
A hospital owned by a Catholic order of nuns will not allow tubal ligations to be performed. This is considered to be:
institutional policy
A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating?
integrity
Modes of value transmission
modeling, moralizing, laissez-faire, rewarding and punishing, responsible choice
A nurse knows that the expression "Do not cause harm" refers to which ethical principle?
nonmaleficence-"equals should be treated equally and unequals should be treated according to their difference"
A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief?
personal moral
Four fundamental responsibilities nurses have:
promote health, prevent illness, restore health, alleviate suffering
autonomy
right to self-determination
ANA- American Nurses Association
who deals with the professional nursing scope and standards of practice; standards of practice and professional performance; all RNs are a part; mission is to advance nursing profession
Bill of Rights for Registered Nurses
right to practice in manner to fulfill obligations right to practice in environments allow to act with professional standards right to work environment supports ethical practice right to freely and openly advocate right to fair compensation right to safe work environment right to negotiate conditions of employment
