You are likely already upholding ethics in nursing and healthcare delivery in your current nursing practice experience. As mentioned in the introduction for this week, a patient-focused approach that promotes the delivery of safe, quality, and cost-effective healthcare for promoting positive patient outcomes represents a fundamental alignment to ethical principles for the delivery of healthcare. In your journey toward becoming a DNP-prepared nurse, you will continue to uphold ethical principles in your nursing practice and will likely continue to serve as an advocate for adhering to these principles in all you do.

For this Discussion, reflect on the case studies/scenarios related to ethical challenges presented in this week’s Learning Resources. Think about how these ethical challenges may mirror your own experiences in nursing practice. Consider what other ethical challenges may arise in your own nursing practice or as you continue your program of study.

Post an explanation of at least two significant ethical issues relevant to the DNP-prepared nurse. Then explain how these issues might compare to the types of issues you have encountered in your practice. Be specific and provide examples.

Required Readings

• Pavlish, C. L., Henriksen, J., Brown-Saltzman, K., Robinson, E. M., Warda, U. S., Farra, C., Chen, B., & Jakel, P. (2020). A team-based early action protocol to address ethical concerns in the intensive care unit. American Journal of Critical Care, 29(1), 49–61. https://doi.org/10.4037/ajcc2020915
• Phelan, P. S. (2020). Organizational ethics for US health care today. AMA Journal of Ethics, 22(3), 183–186. https://doi.org/10.1001/amajethics.2020.183
• Rejno, A., Ternestedt, B.-M., Nordenfelt, L., Silfverberg, G., & Godskesen, T. E. (2020). Dignity at stake: Caring for persons with impaired autonomy. Nursing Ethics, 27(1), 104–115. https://doi.org/10.1177/0969733019845128
• Torkaman, M., Heydari, N., & Torabizadeh, C. (2020). Nurses’ perspectives regarding the relationship between professional ethics and organizational commitment in healthcare organizations. Journal of Medical Ethics and History of Medicine, 13(17), 1–10. https://doi.org/10.18502/jmehm.v13i17.4658
• Vermeesch, A., Cox, P. H., Baca, S., & Simmons, D. (2018).Strategies for strengthening ethics education in a DNP program. Nursing Education Perspectives, 39(5), 309–311. https://doi.org/10.1097/01.NEP.0000000000000383

Given the critical role of fluid, electrolyte, and acid-base balance in maintaining overall health, how can nurse practitioners effectively assess and identify subtle imbalances in their patients?

Please see the attachment for the Instructions

Eleanor Thompson, a 72-year-old woman, has been battling an aggressive form of ovarian cancer for the past three years. Despite undergoing multiple rounds of chemotherapy and radiation, her condition has deteriorated, and she is now experiencing severe pain and suffering. Eleanor’s oncologist, Dr. Samuel Martinez, has presented the family with the option of another experimental treatment, but he has also suggested considering transitioning to palliative care. Eleanor’s family is deeply divided on the decision. Her eldest daughter, Maria, believes that every possible treatment should be pursued, holding onto hope for a miracle. She argues that her mother has always been a fighter and would want to continue the battle against her illness. On the other hand, Eleanor’s son, Michael, feels that his mother has suffered enough. He believes that transitioning to palliative care would allow her to spend her remaining days in comfort and peace. Caught in the middle is Eleanor’s husband of 50 years, Robert. He is torn between wanting to honor his wife’s fighting spirit, desiring to ease her pain, and the painful finality of either decision. The healthcare team must navigate a complex ethical landscape. Beneficence, the principle of doing good, pushes the team to consider what would truly benefit Eleanor in terms of quality of life. Non-maleficence, or “do no harm,” raises questions about the potential suffering Eleanor might endure with further aggressive treatments. Lastly, the principle of justice requires the team to treat Eleanor fairly and equitably, ensuring her needs are met regardless of family disagreements.
Using the case study above, answer the questions below.

1. Summarize the facts in the selected case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
   • Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
   • Identify who is involved or affected by the ethical problem or issue.
   • Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
     • Apply the three components outlined in the Ethical Decision-Making Model media.
   • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
     • Describe the factors that contributed to the problem or issue and explain how they contributed.
2. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
   • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
     • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
     • Review the Think Critically About Source Quality resource.
       • Assess the credibility of the information source.
       • Assess the relevance of the information source.
3. Discuss the effectiveness of the communication approaches present in a case study.
   • Describe how the health care professional in the case study communicated with others.
   • Assess instances where the professional communicated effectively or ineffectively.
   • Explain which communication approaches should be used and which ones should be avoided.
   • Describe the consequences of using effective and non-effective communication approaches.
4. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
   • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
   • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
   • Discuss the key lessons this case provides for health care professionals.
5. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
   • Describe the proposed solution.
   • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
   • Discuss how likely it is the proposed solution will foster professional collaboration.
6. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
   • Apply the principles of effective composition.
   • Determine the proper application of the rules of grammar and mechanics.
7. Write using APA style for in-text citations, quotes, and references.
   • Determine the proper application of APA formatting requirements and scholarly writing standards.
   • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.