Lena is a community health care nurse who works exclusively with HIV-positive and AIDS patients. As a part of her job, she evaluates new cases and reviews confidential information about these patients. In the course of one of these reviews, Lena learns that her sister’s boyfriend has tested HIV positive. Lena would like to protect her sister from harm and begins to consider how her sister can find out about her boyfriend’s health status.
Consult at least two resources to help you establish Lena’s legal and ethical position. These resources might include your state’s Nurse Practice Act, the ANA’s Code of Ethics, ANA’s Nursing: Scope and Standards of Practice, and internal or external standards of care.
Consider what action you would take if you were Lena and why.
Determine whether the law and the ANA’s standards support or conflict with that action.
Post a description of the actions you would take in this situation, and why. Justify these actions by referencing appropriate laws, ethical standards, and professional guidelines.
Cigarette smoking is as yet the main source of preventable demise in the created world. In the UK it is assessed to cause genuine disease in 4.5 million individuals and slaughters around 300,000 individuals every year. Frieden gauges that it murders 5 million individuals on the planet yearly. (Frieden et al. 2005) This exposition will consider the administration plan for an admired patient who smokes and has as of late been determined to have ischaemic coronary illness. There is a lot of proof in the writing which joins smoking with both expanded frequency and expanded bleakness and mortality in coronary illness. (Molyneux et al. 2004). It pursues in this way that each exertion ought to be made to energize a patient who smokes to stop at the principal opportunity. There is some proof to recommend that one of the ideal occasions to effectively induce a patient to stop smoking is the point at which they have had a smoking related wellbeing occasion. (Ferguson et al. 2003) With regards to this paper one can expect that, having recently been determined to have some type of coronary illness, this would be an ideal time to prompt such a mediation. Pathophysiology Cigarette smoking is known to be a noteworthy wellbeing risk. It is altogether involved in essentially all parts of both cardiovascular horribleness and mortality. (Missel et al. 2008). Regarding pathophysiology, cigarette smoking affects all periods of the atherosclerotic procedure from the most punctual perceivable indications of endothelial brokenness to clinically noteworthy thrombotic clinical occasions. There gives off an impression of being little distinction in the ramifications of dynamic or aloof smoking as the impacts seem, by all accounts, to be generally dosage (presentation) related. (Heiss et al. 2008). The instruments by which cigarette smoking applies its obsessive impacts are unpredictable, yet it is known to expand irritation, upgrade the thrombotic procedures and builds the oxidation of LDL cholesterol. Cigarette smoking expands the oxidative weight on the body. (O'Connell et al. 2008). These smoking-particular impacts are aggregate. Furthermore, there is proof to help the view that inducing a patient to decrease his admission is gainful, despite the fact that this is obviously not as advantageous as total discontinuance. (Wood-Baker 2002) Objectives Any administration plan ought to in a perfect world have objectives. This does not infer that they will all be accomplished, but rather the majority of the procedures distinguished and exercises set out on ought to have the perfect objective as their definitive target. In this specific case, one can characterize a few objectives which will aid the way toward smoking suspension and administration of their coronary illness. A) To guarantee that the patient comprehends their condition. B) Empowerment and instruction of the patient so they can partake in their administration plan with comprehension and duty C) To help the patient in the therapeutic treatment of the intense period of their condition. D) To restore the patient after the intense stages are balanced out E) To draw in with the patient's carers (formal and casual) to enhance the patient's arrival to wellbeing F) To help the patient to stop smoking G) To help the patient as they arrange their ailment direction. Unmistakably there may well be different objectives that could be considered and may emerge in particular cases. This exposition notwithstanding, is managing the summed up patient. These objectives are accordingly intended to be appropriate to the larger part of instances of patients who smoke and have coronary illness. Appraisal The appraisal of a patient starts at the principal purpose of contact. Data can be gathered from numerous sources and ought to be suitable to the introducing condition. Appraisal ought to be all encompassing and careful. In this particular case, one should make specific enquiries identifying with components that are pertinent to the patient's way of life (pertinence to their coronary illness) and to their own propensities (significance to their smoking example). One should give careful consideration to the variables that may make them wish to endure in their propensity for smoking with the goal that they can be particularly tended to when smoking end is examined. Directed intercessions will probably be viable than cover ones. (Rigotti et al. 2004). With regards to their coronary illness, one should make particular enquiries in connection to their eating and exercise propensities and additionally their readiness to partake in any proposed way of life change program that might be recommended. Intercessions and wide nursing methodologies. Obviously the expression "coronary illness" covers a huge number of potential pathologies and it isn't reasonable to think about particular intercessions for all conceivable outcomes. With regards to this exposition, one will consider wide techniques which are relevant to generally circumstances. 1) Encourage consistence with medication regimens: Medications are generally endorsed in relationship with coronary illness. They can be as a feature of an essential mediation, for example, controlling pulse (antihypertensives) or maybe to enhance cardiovascular yield (digoxin) or for controlling auxiliary pathologies (viz. lipid bringing down medicine, diabetic treatment, anticoagulants). There is a case for utilizing nicotine substitution prescription. If so then consistence with a suitable measurement and diminishing administration will upgrade the probability of progress. (Parrott et al. 2004) The medical attendant can help by urging the patient to agree to the administration. They may do this by disclosing to the patient why the different medications are imperative and how they function or, if consistence is a tenacious issue, by going about as the patient's backer and talking about with other human services experts if elective dosing administrations may help consistence. 2) Facilitate recuperation from the ailment: This is a tremendous theme and will, to an expansive degree, be subject to the infection procedure. Obviously the patient who has unobtrusive hypertension will require very unique contribution from the patient who has quite recently supported a noteworthy myocardial localized necrosis. In the intensely incapacitated patient, the attendant should play a more dynamic and handy job than with the ambulant and generally well patient. In light of the accentuation of this article on smoking discontinuance one can particularly incorporate this as a noteworthy undertaking around there of the administration plan. The particular points of interest and treatment alternatives will be talked about later. There is proof that by helping the patient to stop smoking, this will specifically aid the recuperation procedure from the coronary illness. (Siahpush et al. 2003) 3) Provide passionate help: This might be pertinent in the patient who smokes principally for reasons of tension or stress. Investigation of the causative components is obviously important if any focused on methodologies will be powerful. In the event that the coronary illness is recently analyzed, extra help might be required to enable the patient to adjust from an apparent wellbeing job to a disease job. (Roy. 1991). In this portion one should take note of that there is some recommendation that the tension once in a while caused by the way toward smoking discontinuance can be counter-profitable to the treatment of a few types of coronary illness. There does not have all the earmarks of being a solid proof base to help this instinctive view be that as it may. (Sullivan et al. 2007) 4) Prevent the illness: It is realized that patients who have smoked will dependably have a higher lifetime danger of illness than the individuals who have never smoked. Supreme counteractive action is hence impractical. Patients who smoke and are then induced to stop, can diminish their dangers extensively. It is realized that patients who quit smoking will diminish their dangers of myocardial localized necrosis by half in the main year of smoking end. (Prescott et al. 1998) Expected result One can want to help the larger part of patients to stop smoking. To some extent, one needs to acknowledge that there will dependably be a safe core of people who will (for reasons unknown) essentially not surrender. It isn't conceivable to foresee, ahead of time of the intercession, which patients will be in the gathering that in the end backslides, in this way all patients ought to be helped similarly forcefully. On the off chance that one thinks about the consequences of the Hilleman preliminary, one is looked with the exceptional prospect that in an investigation of post CABG patients (who one may accept had the best motivating force to stop smoking) an amazing 84% were back smoking inside 10 weeks of the task regardless of a gigantic contribution of hostile to smoking publicity. (Hilleman et al. 2004) Quiet strengthening and instruction Various sources feature quiet strengthening and training as one of the prime indicators in a positive choice to stop smoking. (viz. Edwards 2004). On the off chance that a patient comprehends the thinking behind why they are being requested to embrace a wellbeing program they will probably consent to it. Training is hence one of the central point in the different projects intended to enable patients to surrender smoking. Strengthening is another prime factor. Numerous examinations have featured the need to pressure self-confidence in the patient and that the level of self-conviction compares firmly with a positive outcome. (viz. Mill operator et al. 2003) Smoking end A concise diagram of the writing on smoking suspension will show that the subject is huge and that a wide range of methodologies have been attempted with changing degrees of accomplishment. It isn't suitable to think about the majority of the different alternatives, yet this paper will cover those that seem to have the best announced degrees of progress. Fung considered intercessions that were reasonable for hospitalized patients and of the four unique administrations trialed, found that an administration which consolidated vis-à-vis advising to distinguish hazard factors for smoking Support, individualizing counsel about stopping, including patients in training measures (especially investigation of the wellbeing impacts and the advantages of stopping), was the best. (Fung et al. 2005). The creators additionally make the c>GET ANSWER