Nurses category. (McKinney et al., 2013). Medical
Nurseshave a responsibility to provide the highest level of care possible to anypatient this is outlined in the basic nursing ethics. Four mostimportant principles are beneficence, nonmaleficence, autonomy, and justice (McKinney, James, Murray, Nelson, &Ashwill, 2013). Beneficence is providing and promoting good for all patients. Nonmaleficence is avoid riskingand causing harm to others (McKinney et al., 2013). Autonomy is for thepatient, this includes the right to respect, privacy, and the informationnecessary to make decisions (McKinney et al., 2013).
An example of this isproviding surgical interventions and drug interventions and letting the patientchoose what they want. Justice is all people should be treated equally andregardless of disease or social, economic status (McKinney et al.,2013). An example of this includes care for ahomeless and a wealthy person are the same (McKinney et al.
, 2013). Physical parametersSean is6 years old and is 40 inches tall and weighs 35 pounds. His BMI is 15.4 whichfall in the underweight category. (McKinney et al.
, 2013).Medical or hereditaryThereason for his growth can be related to his medical past. Pyloric stenosis maybe the cause for his low weight (McKinney et al., 2013).
His mother also had precocious puberty. Precocious puberty is rapid bone growth thatresults in early growth plate fusion leading to short staturein adulthood as compared to genetic height potential (McKinney et al., 2013). Thiscannot be confirmed since Sean is still a child and adulthood stature may notbe able to be determined right now. His family history includes hypopituitarism,and this can cause short stature and slow growthand also delayed puberty which may be the cause for Sean’s short height. Thedecision to administer growth hormone is not dependent on whether the disease is medical or hereditary.In this case autonomy which is the ability for the patient to choose willdetermine if the family and patient agree to this treatment after consultingthe doctor.
Nonmaleficence is doing no harm in this situation if this treatmentwere to cause immediate harm or danger to the patient the nurse would let thepatient and family know about these risks and it would be their decision toproceed or not, in this case Sean does not want any painful procedures.Beneficence is promoting good for others, and if this treatment helps withphysical or psychosocial development the nurse would promote the benefits.Disability: Physiological or psychological consequences to beingshort.
Beingshort is not a disability, however the child may display psychologicalconsequences of being short. These may include low self-esteem, the child may start demonstrating poor school performanceand show a lack of interest in sports and other activities (McKinney et al.,2013). These consequences of being short can lead the child to develop socialanxiety and a lack of confidence because of bullying in school (McKinney etal., 2013). Economic consequences maycome up in the cost of treatment and adulthood if they cannot preform well in ajob or get a job due to the lack of confidence and feeling intimidated thattheir height will always determine how they are treated. Physical andpsychosocial benefits and risks of administering growth hormone.
Sean’s rights. The physical benefits of administering growth hormone is that Seanwill grow 4 inches the first year, then three inches per year for two more yearsafter the growth rate slows (McKinney et al., 2013).
If treatment is started on a youngerchild the greater the height potential, and growth hormone therapy typicallycontinues until the growth plates are closed or until they have reached anacceptable or predicted final height (McKinney et al., 2013). The risks ofadministering growth hormone include behavioral changes, headaches, back pain(Mayo clinic, 2015). Sean is 6 years old now and his parents have the decisionto go ahead with the procedure. The child should be given the correctinformation about a procedure at a developmentallyappropriate format, so he can understand (McKinney et al., 2013). Autonomy could be violated in this casebecause Sean has stated he does not want any painful procedures and if theparents go ahead with this treatment pain is one of the side effects.
In conclusion, the main benefits of the growth hormoneare the child’s psychological development may not be affected because it putsthem at a lesser chance of being bullied for their height. Physically Seanwould begin to grow and be more on track with other children his age. Theparents have the final say of agreeing to the treatment for him. If the parentsagree to the treatment it should begin now since Sean is young and if will bemore beneficial to begin now. The benefits for this treatment weigh out therisks and starting the growth hormone now will save Sean from any psychologicalconsequences later in adulthood.