Chapter_004.pptx

Chapter 4 Cultural, Legal, and Ethical Considerations  Audience Response System Question #1 What percentage of all Americans are predicted to belong to a minority group by the year 2044? A. One-fourth B. One third C. One half D. Three fourths NOTE: No i...

Chapter 4 Cultural, Legal, and Ethical Considerations  Audience Response System Question #1 What percentage of all Americans are predicted to belong to a minority group by the year 2044? A. One-fourth B. One third C. One half D. Three fourths NOTE: No input is required to proceed. 2  Answer to System Question #1 ANS: C By 2044, more than half of all Americans are projected to belong to a minority group. 3  Ethnopharmacology  Body of knowledge for understanding the specific impact of cultural factors on patient drug response  Lack of clarity in terms: race, ethnicity, and culture 4  Cultural Considerations  Pharmacogenomics: study of how certain genetic traits affect drug response  Drug polymorphism  Adherence with therapy  Environmental and economic considerations  Pharmacokinetics  Pharmacodynamics  Varying drug responses in different racial or ethnic groups 5  Cultural Considerations (Cont.)  Health beliefs and practices  Barriers to adequate health care for the culturally diverse U.S. patient population  Language, poverty, access, pride, and beliefs regarding medical practices  Medications may have a different meaning to different cultures. 6  Cultural Assessment  Languages spoken: need for interpreter  Health beliefs and practices  Past uses of medicine  Herbal treatments, folk remedies, and home remedies  Use of over-the-counter drugs 7  Cultural Assessment (Cont.)  Usual response to illness  Responsiveness to medical treatment  Religious practices and beliefs  Support from the patient’s cultural community  Dietary habits 8  Audience Response System Question #2 Which of the following statements regarding African Americans’ responses to antihypertensive medication therapy is true? A. African Americans respond better to diuretics than to beta blockers. B. African Americans do not respond to diltiazem. C. Single-drug therapy is effective for African Americans. D. Hypertension is uncommon in the African-American population. NOTE: No input is required to proceed. 9  Answer to System Question #2 ANS: A African Americans respond less effectively to beta blockers. African Americans respond best to calcium channel blockers, especially diltiazem. African Americans respond less effectively to single-drug therapy. 10  Legal Considerations  Food and Drug Administration (FDA)  Drug Enforcement Agency (DEA)  Individual state laws 11  HIPAA  Health Insurance Portability and Accountability Act (HIPAA)  1996  Maintain privacy regarding protected health information 12  New Drug Development  Food and Drug Administration (FDA): primary purpose of the FDA is to protect patients and ensure drug effectiveness.  Dietary Supplement Health and Education Act of 1994  National Center for Complementary and Alternative Medicine of 1998 13  New Drug Development (Cont.)  Expedited drug approval process  U.S. FDA drug approval process  Preclinical testing  Clinical studies  Investigational drug studies  Expedited drug approval 14  U.S. FDA Drug Approval Process  Informed consent  Investigational new drug study  Preclinical investigational drug studies  Clinical phases of investigational drug studies  Phase I  Phase II  Phase III  Phase IV 15 U.S. FDA Drug Approval Process (Cont.)  Black box warning  Drug recall  Class I (most serious)  Class II  Class III 16  Audience Response System Question #3 A research group is conducting an investigational drug study on a promising new drug for osteoporosis. It has been difficult to find research participants who meet the criteria. Just before the conclusion of the study, four participants approach the researchers and express their desire to withdraw from the study. What is the researcher’s priority intervention? A. Inform them that they waited too long to withdraw from the study. B. Explore with them the reasons for withdrawing from the study. C. Acknowledge that they can withdraw at any time from the study. D. Request that they try to remain with the study until it is completed. NOTE: No input is required to proceed. 17  Answer to System Question #3 ANS: C The researcher may try to find the reasons for withdrawal and request that the participants try to remain with the study, but the individuals must know that their participation is truly voluntary and that they can quit the study at any time. 18  Legal Considerations Related to Drug Therapy and Nursing Practice  State and federal legislation  Nurse practice acts  Scope of nursing practice  Expanded nursing roles  Educational requirements  Standards of care  Minimally safe nursing practice  Differences between nursing and medical practice 19  Legal Considerations Related to Drug Therapy and Nursing Practice (Cont.)  Guidelines from professional nursing groups  American Nurses Association (ANA)  Institutional policies and procedures; state and federal hospital licensing  Specific Nurse Practice Acts  Standards of Practice  HIPPA 20  Ethical Terms Related to Nursing Practice  Autonomy  Beneficence  Autonomy  Confidentiality  Justice  Nonmaleficence  Veracity 21  Audience Response System Question #4 A nurse does not notice that a patient’s IV site is swollen, red, painful, and warm to touch nor that the IV has quit infusing properly. What ethical principle does this involve? A. Breach of duty B. Duty C. Causation D. Damage NOTE: No input is required to proceed. 22  Answer to System Question #4 ANS: A Refer to Teamwork and Collaboration: Legal and Ethical Principles: Elements of Liability for Nursing Malpractice box on page 58 in the textbook. 23 Legal and Ethical Principles: Elements of Liability for Nursing Malpractice  Duty  Breach of duty  Causation  Damage 24  Ethical Considerations  ANA Code of Ethics for Nurses  International Council of Nurses Code of Ethics for Nurses  Use of placebos 25  Audience Response System Question #5 A nurse has been asked to participate in an elective procedure that violates the nurse’s personal ethical principles. What is the nurse’s best action? A. Refuse to participate. B. Ask to switch assignments with another nurse. C. Speak to the manager or supervisor. D. Perform the procedure. NOTE: No input is required to proceed. 26  Answer to System Question #5 ANS: C The nurse has a right to refuse to participate in any treatment or aspect of patient care that violates the nurse’s personal ethical principles. However, this should be done without deserting the patient. The matter should be discussed with the manager or supervisor so that a change in assignment can be approved. 27