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DUE 3/11/189am New York Time Zone (eastern )Word Count 150 minimum for each post Provide PLAG. Report**Read Below & Reply To Both Post* What guidance does the Code of Ethics for Nurses with Interpretive statements provide for a situation like the one at Memorial Hospital Medical center in New Orleans? To view the article, http://journalofethics.ama-assn.org/2010/09/hlaw1-1009.html . After reading the link above and the question presented do you agree with the reply post why or why not ? Give documentation to support your decisionReply 1: The history of hurricane Katrina and New Orleans, LA is a devastating one. The devastation that ran through the city for the days, weeks, and months after the hurricane was heartbreaking. People all over were pushed to the limits and expected to find ways to survive until help could be reached. This was not only for the hospitals in the city but also for the residents and other businesses. What happened at Memorial Medical Center was sad and led to bad outcomes but these healthcare professionals were asked to do the impossible in impossible conditions.Dr. Pou, I believe did the best she knew how to do in this impossible situation. Provision 4 states, “The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care” (Butts & Rich, 2016, pg. 473). These patients that they were trying to keep comfortable and healthy over these days of no power, air conditioning, and access to proper medical equipment were in pain and their health was quickly deteriorating despite the staffs best efforts. Dr. Pou believed that to provide optimal care to these patients was to help relieve some of their pain and suffering by sedation and giving them morphine. When making a decision like this it is her responsibility to make sure this was the right call for these patients that were dying and still trapped inside the hospital with limited resources. But, the provision also states that she must be held accountable for her actions. Which is what ultimately happened when an investigation took place.Only the people that were there those four days truly understand and know the chaos that happened at Memorial Medical Center. Unfortunately sometimes when asked to do the impossible and help 180 patients to the best of your abilities mistakes get made, even if at the time it seemed like the right call. I feel as though provision 4 best guides someone for this type of situation as you must act in the patients best interest to deliver optimal care, show responsibility, but also must be held accountable.(BAKER)Reply 2: The case of Dr. Pou and the two other nurses who were charged for killing their patients during the aftermath of Hurricane Katrina brings up ethical concerns and debates on whether or not what she decided was the correct decision. The Code of Ethics provides plenty of information on what to do in situations and guidelines to follow. In my clinical methods course we talked a little bit about ethics and rules that speech language pathologists have to follow. We discussed how the guidelines provide information for an ideal world or situation but many times it is not actually like that. I think this is a good example of the Code of Ethics falling short to provide information on what to do in a situation like this—which is in my opinion unrealistic information to be able to give. There are several different provisions that I think apply to this case. First, provision 2 states “the nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population” (Butts & Rich, 2016, p. 466). Specifically, it discusses conflicts of interest and collaboration with other nurses and professionals. I think Dr. Pou and the nurses could have consulted more people to get opinions on what to do, it is possible that another physician or nurse would have another idea that doesn’t require sedating patients. Next, provision 4 states, “The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care” (Butts & Rich, 2016, pg. 473). I think this provision provides very useful information and guidelines. Nurses are accountable and responsible for the care that their patients receive. Dr. Pou and the nurses made the decision based on several different factors. It seems like they knew what they were going to do and thought that the positives outweighed the negatives and were ready to take responsibility for their actions. Last, I believe that there are specific provisions that need to be thought about in a situation like this and that this unfortunate and traumatic event can be a learning lesson for other health care professionals everywhere. ** Read Below & Reply to Both Post **Read both post below about the role of the urinary system in homeostasis & decide whether or not you agree or disagree with their assessment? Provide documentation to support your decision.Reply 1: The urinary system, specifically the kidneys, play a very important role in maintaining homeostasis in the body. The kidneys work diligently to remove metabolic wastes from the blood, regulate fluid and electrolyte levels, regulate pH levels, maintain blood pressure, and regulate red blood cell production in the bone marrow by releasing erythropoietin (Amerman, 2015). The combination of these functions helps to keep the body in a constant state of homeostasis. (Russo)Reply 2: The body system that responsible for waste excretion is the urinary system. The urinary system includes two kidneys and the urinary tract. The urinary system maintains blood homeostasis by filtering and eliminating wastes and other substances from the bloodstream. This allows the urinary system to control body fluid volume, blood pressure, acid-base, and electrolyte balance (Amerman, 2015). For example, when blood pressure is elevated, the kidney can help to reduce blood pressure by reducing the volume of blood in the body.(ZININA)** ** Read Below & Reply to Both Post **Read three post below on two different disease’s and decided whether or not you agree with the post and provide 2 separate academic resources to support your answerReply 1 Tinnitus: Have you’ve ever been to a loud concert or spent the night dancing away with the music blasting in a club and wake up with you hearing buzzing, ringing, or hissing in the ears? If so this means you have experienced Tinnitus, if not it is more then likely you will in your lifetime. This is common problem that effects 1 in 5 people. Besides exposure to loud noise other causes of the symptoms include age related hearing loss starting around the age of 60, earwax blockage, and changes in the ear bones (stiffening of the bones). More uncommon causes includes Meniere’s disease, TMJ disorder or head/neck injury. These causes affect the trigger ear cells that release a electrical signal through the auditory nerve to the brain which interprets the signal as sound. There are multiple treatment options for Tinnitus to include Earwax removal, changing medications if symptoms occured after starting a new medication, noise suppression (white noise machines), hearing aids, or some medications to include Amitriptyline, Niravam, Xanax, and Nortriptyline.(MARTINEZ)Reply 2 Anosmia/Hyposmia: Anosmia is a lack of olfaction or sense of smell. Anosmia can result from any condition that blocks air from reaching the olfactory epithelium including but not limited to deviated septums, nasal polyps, head injuries, and allergic reactions or respiratory infections that result in swollen respiratory epithelium (Ammerman, 542). Anosmia can be temporary with the return of airflow to the olfactory epithelium. In other cases, anosmia is permanent, this is especially true in cases of neural degeneration caused by diseases like Alzheimer’s and Parkinson’s (Ibid). Fracturing of the cribriform plate is particularly dangerous for the olfactory nerve as this can lead to damaging of the neural pathways such as in the case of head injuries (Ibid). Head injuries are one of the leading causes of anosmia, with up to 30% of head injuries presenting with anosmia (Mueller and Hummer, 1). In a lesser form, hyposmia is the reduction in olfactory sensitivity (Ibid). Anosmia or hyposmia are estimated to affect between 3%-20% of the population globally (Boesveldt Et Al, 513). Disorders related to the olfactory nerve can cause risk in being able to recognize dangers in environmental factors and food (Boesveldt Et Al, 513). Many people who suffer from anosmia or hyposmia often believe they have lost their sense of taste as well which highlights the connection to the nasal cavity in relation to what we actually taste (Toller, 706). To treat anosmia or hyposmia, topical and systemic steroids (Welge-Lussen, 1). Nasal sprays and surgery to remove nasal polyps can be helpful in reducing the blockage within the nasal cavity (Ibid). However, surgery is not a guaranteed to improve olfactory function.(clark)Reply 3 Sjogren Syndrome: Recognized by its two most typical symptoms, dry eyes and mouth, Sjogren’s syndrome is an autoimmune disorder related to the special senses, more specifically the senses of vision and taste (Mayo Clinic, 2017). In this condition, the lacrimal apparatus and salivary glands of the eyes and mouth are most commonly impacted first. As the lacrimal apparatus is a key player in tear production, those suffering from this condition not only experience the common symptom of dry eye, but also further problems such as blurred vision, corneal damage, and light sensitivity (Mayo Clinic, 2017). Essentially, due to Sjogren’s, an inadequate number of tears are produced and carried to the conjunctival sac. Therefore, the eyes not only become dry, but also lose the ability to clear dust and foreign matter away (Amerman, 2015). Further, as tears play a key role in focusing light, vision can be greatly disrupted (National Eye Institute, 2017). Additionally, Sjogren’s syndrome can cause the salivary glands to swell (Sjogren’s Syndrome Foundation). While this is not only quite painful, it can also result in decreased saliva cell production. As substances must first dissolve into saliva to find the taste buds, this has the potential to disrupt the special sense of taste (Amerman, 2015). Moreover, though less common, this condition can impact the sense of smell, as it can result in hyposmia (Sjogren’s Syndrome Foundation).While the exact cause of Sjogren’s syndrome is unknown, researchers have found a genetic link in this cognition. Further, it can develop as a complication of additional diseases, such as lupus and rheumatoid arthritis (Mayo Clinic, 2017). Overall, as more than four million Americans are living with this condition, Sjogren’s syndrome is quite common (Sjogren’s Syndrome Foundation). On top of the diagnosis of additional conditions, risk factors include age, with individuals most typically being diagnosed after age forty, and sex, with nine out of ten patients being women. Moreover, though this condition is difficult to diagnose, specific tools, such as the Schirmer tear test, can assist in making this conclusion. Treatment most typically focuses on managing the dry eye and mouth symptoms, with providers prescribing artificial tears and drops such as Restasis, as well as medication to increase saliva production (Mayo Clinic, 2017). In the most severe cases, surgery can also be an option.** Read Below & Reply to Both Post **Read two posts below and based on their response to their footprint results provide any new suggestions you feel that could help them shrink their score. Use link if needed http://footprint.wwf.org.uk/Reply 1: My carbon breakdown is broken down into: Food: 30%,Home: 52%,Travel: 8%,Stuff: 9% My footprint is a little larger than the world average but much smaller than the UK average. My footprint score was: 71%. I was not surprised that I scored the highest in the ‘home’ category because I live in on campus housing and have little to no control of how the house was built and the energy sources. When I graduate, I will work to find housing that is more environmental friendly and shop more locally sourced foods. I hope that in the near future in America, there will will be more regulations and policies put in place to promote environmental security for our world. Ideas I have include: having solar panels, water limits, and heating and cooling limitations. Reply 2: I was extremely surprised by my results after completing the short survey – I was at 100% of the carbon footprint used as a baseline. It’s nice to know that I’m not living in a way that dramatically has a negative impact on the environment through a large carbon output. I would have guessed that my lifestyle was pretty sustainable given that I rely on public transportation, prepare many of my own meals and try my best to live within my means and not purchase an excess of things.After looking at the results of the quiz it was apparent that most of my carbon footprint results from my food and eating habits. While I only eat out once or twice a week, I do not actively try to purchase local or seasonal foods. I have always worked during the time of local farmers’ markets, so have never gotten in the routine of visiting them. In addition to changing the way in which I approach food, I could certainly try to make my home more efficient. Living in apartments makes this difficult because I can not replace my appliances with low energy versions or replace my windows for double paned versions. While I could look for a more sustainable building, the cost of having these luxary features puts many buildings of this nature out of my price range. (SWINEFORD)
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