Reference no: EM133882178

Question 

Mention an ethical dilemma from each case study, and describe the challenges that this issue poses for practicing APNs. Give specific examples.

Scenario 1: Mrs. Brown, an 89-year old female, was hospitalized three days ago for weakness and fever. Yesterday, she was diagnosed with lung cancer. You are the nurse practitioner on the hospitalist service preparing to visit Mrs. Brown this morning. As you gather pertinent information from the patient chart outside of the room, her daughter asks if she can speak with you. You agree and walk to a private area for the conversation.Mrs. Brown's daughter tells you that the family held a meeting last night and says, "We decided not to tell Mom that she has cancer." She tells you that they are telling Mrs. Brown that she has pneumonia and that she just needs a few days of antibiotics to get better. Family members are requesting that all hospital staff and care providers tell Mrs. Brown the same thing. Her daughter said, "Mom has always been afraid of cancer. We know she will just give up if we tell her the truth.

Scenario 2: You are a nurse practitioner in a practice where Alexandra, a 16 year-old female, has been a patient since infancy. She is at the office today for abdominal pain and nausea/vomiting. When seeing adolescent patients, you usually update the history and ask about any specific questions or concerns while the parent is in the exam room. Then you ask the parent to step outside for the actual exam. This allows time for adolescent patients to provide additional information about their history or condition and to ask you any questions they may not feel comfortable with when their parent is in the room.

Alexandra's mother asks you to step outside the exam room for a moment. She expresses concern that Alexandra has not been acting like herself lately.

You go back in the room to examine Alexandra and ask if she is sexually active. She states that she is nervous that you will tell her mom. You reassure her that this information is confidential. She states that she is having sex with her boyfriend and when you ask, she says that she isn't using any birth control. She doesn't really remember when her last period was because it isn't regular so she doesn't keep track.

You tell Alexandra that you need to do a urine pregnancy test. The test comes back positive, and Alexandra is very distraught. You ask if she would like for her mom to come in the room so that you can discuss this with both of them. She adamantly tells you that she does not want her mom to know. You talk with her about getting an appointment with an OB-GYN and discuss the importance of talking with her mom about the pregnancy when she is ready. She takes the information you give her and leaves the exam room.

A few hours later, you receive a phone call from Alexandra's mom asking what you found during the exam. She says that Alexandra seems very upset and she does not say why. As Alexandra's healthcare provider, what do you say to her mom?