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Reduction of Legal Obligations when dealing with Nurse Administration
There are a number of legal risks that health care administrators and managers can receive in their
workplaces and most of these legal risks are due to inadequate staffing, disadvantageous
documentation, negligent hiring, lack of supervisory management, and nonadherence with policies and
procedure. Of these, poor staffing is of great concern. Patient injury, medication mistakes, and the rise
in workload may occur due to short staffing, which poses a liability risk to the institutions (Guido, 2020).
One more significant risk in the legal sector is the lack of documentation properly done- failure to
document is equal to failure to happen legally, as the lack of documentation may cause some problems
during the legal audit or when a patient sues.
In order to reduce the liability associated with them, nurse managers must adhere to the set
procedures, education of the staff employees on a continuous basis, and have a culture of safety and
transparency. Most errors are also minimized by training the staff consistently on documentation, risk
management and ethical decision-making. Evidence-based staffing models supplemented by regular
audits of staffing levels, and incident report can also help to promote legal protection and high-quality
care.
To sum it all up, even though nurse administrators face threats of legal liability, a comprehensive
strategy involving training, enforcement of policies, and the regular supervision process can help
diminish anticipated liabilities to a considerable degree, and improve patients outcomes.
References:
Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Pearson.
American Nurses Association (ANA). (2015). Code of ethics for nurses with
interpretive statements. https://www.nursingworld.org/coe-view-only
518
Anti-NMDA Receptor Encephalitis- A Treacherous Imitator of Psychiatric Disorders
Among the diseases that can be misdiagnosed with dramatic consequences, one can describe anti-
NMDA receptor encephalitis, which is usually linked to ovarian teratomas. The disease, which has an
autoimmune origin, causes psychiatric manifestations (hallucinations, agitation, paranoia, and
catatonia), so the clinician may initially believe the problems to be of schizophrenic type or manic-
depressive disorder (Dalmau et al., 2007). Nevertheless, over time the development of the disease can
be characterized by seizures, autonomic instability, hypoventilation or respiratory or cardiac arrest in
patients, especially those untreated at a psychiatric hospital.
Clinical presentation of these is flu like illness at the beginning followed by quickly increasing psychiatric
and neurological symptoms, such as psychosis, memory loss, dyskinesias and impaired consciousness.
The psychiatric illness, viral encephalitis (particularly by HSV), neuroleptic malignant syndrome,
substance-induced psychosis are common differential diagnoses.
The condition is becoming increasingly identified, more so in young women despite still being deemed
as infrequent. It is established that anti-NMDA receptor encephalitis comprises as much as 4 percent of
encephalitis cases in a year (Titulaer et al., 2013). Failure or delay in the diagnosis of this condition may
cause an irreversible brain damage or death.
The key to preventing misdiagnosis consists of staying highly suspicious about young patients who
develop their psychiatric symptoms abruptly, especially in the presence of neurological symptoms or
autonomic instability. EEG, CSF analysis and testing of antibodies- in addition to abdominal imaging to
exclude teratoma are some of the most crucial examinations in early detection. Psychiatric, neurological,
and gynecological cooperation has a drastic impact on the outcome.
References:
Dalmau, J., Tüzün, E., Wu, H. Y., Masjuan, J., Rossi, J. E., Voloschin, A., ... &
Lynch, D. R. (2007). Paraneoplastic anti–N-methyl-D-aspartate receptor
encephalitis associated with ovarian teratoma. Annals of Neurology, 61(1),
25–36. https://doi.org/10.1002/ana.21050
Titulaer, M. J., McCracken, L., Gabilondo, I., Armangué, T., Glaser, C., Iizuka,
T., ... & Dalmau, J. (2013). Treatment and prognostic factors for long-term
outcome in patients with anti–NMDA receptor encephalitis: An observational
cohort study. The Lancet Neurology, 12(2), 157–
165. https://doi.org/10.1016/S1474-4422(12)70310-1
512
Subj. Title: Enhancing Health Equity of the LGBTQIA+ Community
Discussion Post:
There have been some significant changes in the health policy and practice since the writing of the
article by Krehely on the gap in healthcare regarding LGBT in 2009. There has been more focus on
culturally competent patient care, non discriminatory care, as well as inclusion of health care coverage.
The most notable changes have been those that provide legal protection through federal policies such as
gender identity and sexual orientation identification with the provision of non-discriminatory policy in
the realm of health.
In 2009 the President Obama issued their directive on the extension of the benefits of the domestic
partner to the same-sex partners of the federal employees it was a groundbreaking policy. It was also
the representation of how the federal government recognized LGBTQIA + relationships and made sure
that same-sex couples received the healthcare benefits they required. This step was critical towards
closing the care disparities barriers and created more fair access to services or safeguards that were
traditionally available to heterosexual couples.
The interaction between the healthcare provider in the scenario when he/she instantly linked the sexual
orientation of the patient with risk of HIV infection and alcohol consumption is unacceptable. It shows
discrimination and encourages stigma. Rather, more respectful and professional tone would be to
suggest open-ended and behaviour-based questions. An answer like; Nice to know. I would like to
discuss any particular health issues or preventive care services that you may require but no assumption
is made and you are respected as a person based on your identity.
References:
Krehely, J. (2009). How to close the LGBT health disparities gap. Center for
American
Progress. https://cdn.americanprogress.org/wp-content/uploads/issues/
2009/12/pdf/lgbt_health_disparities.pdf
Human Rights Campaign. (2024). Legal protections for LGBTQ+ people under
the new Section 1557 final rule. https://www.hrc.org/resources/legal-
protections-for-lgbtq-people-under-the-new-section-1557-final-rule
Now
510
Subject Title: Case Study 79 Osteoporosis
Discussion Post:
The Case Study #79 character is suffering from back pain and has a visible height loss, the key symptoms
of osteoporosis. Osteoporosis is a skeleton metabolic disease that is progressive, has low bone quantity,
and microarchitectural degradation in the bone structure, which causes increased fragility of the bone,
and an increased likelihood of the break.
Those are the risk factors in the given situation: advanced age, female sex, postmenopausal condition,
inadequate calcium and vitamin D consumption, physically inactive lifestyle, and potential tobacco or
alcohol consumption. Fracture within the family or previous low-impact fracture also predisposes
osteoporosis.
A diagnosis is confirmed by a dual-energy X-ray absorptiometry (DEXA) scan. An inferior score of the T-
score of -2.5 or below is an indication of the presence of osteoporosis. The supporting labs can comprise
serum calcium and phosphate levels, the level of vitamin D, and thyroid functions to exclude the
secondary causes.
Management implies a lifestyle and pharmacologic treatment. The patient is to be put on calcium and
vitamin D supplements with a lifestyle intervention to exercise via loading weight and falls. One-line
treatment is normally bisphosphonates. Denosumab or anabolic reagents (teriparatide) can be
prescribed in the case of intolerance or contraindications.
Education of the patient is crucial and it should target at observing the long-term use of medication,
home safety, nutrition, and the need to quit smoking or alcohol abuse. It is important to prevent falls
and enhance a healthy bone structure in order to decrease the danger of subsequent fractures.
References:
Cosman, F., de Beur, S. J., LeBoff, M. S., Lewiecki, E. M., Tanner, B., Randall,
S., & Lindsay, R. (2014). Clinician’s guide to prevention and treatment of
osteoporosis. Osteoporosis International, 25(10), 2359–
2381. https://doi.org/10.1007/s00198-014-2794-2
Eastell, R., Rosen, C. J., Black, D. M., Cheung, A. M., Murad, M. H., & Shoback,
D. (2019). Pharmacological management of osteoporosis in postmenopausal
women: An Endocrine Society clinical practice guideline. The Journal of
Clinical Endocrinology & Metabolism, 104(5), 1595–
1622. https://doi.org/10.1210/jc.2019-00221
