have a responsibility to provide the highest level of care possible to any
patient this is outlined in the basic nursing ethics. Four most
important 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 risking
and causing harm to others (McKinney et al., 2013). Autonomy is for the
patient, this includes the right to respect, privacy, and the information
necessary to make decisions (McKinney et al., 2013). An example of this is
providing surgical interventions and drug interventions and letting the patient
choose what they want. Justice is all people should be treated equally and
regardless of disease or social, economic status (McKinney et al.,
2013). An example of this includes care for a
homeless and a wealthy person are the same (McKinney et al., 2013).
6 years old and is 40 inches tall and weighs 35 pounds. His BMI is 15.4 which
fall in the underweight category. (McKinney et al., 2013).
Medical or hereditary
reason for his growth can be related to his medical past. Pyloric stenosis may
be the cause for his low weight (McKinney et al., 2013). His mother also had precocious puberty. Precocious puberty is rapid bone growth that
results in early growth plate fusion leading to short stature
in adulthood as compared to genetic height potential (McKinney et al., 2013). This
cannot be confirmed since Sean is still a child and adulthood stature may not
be able to be determined right now. His family history includes hypopituitarism,
and this can cause short stature and slow growth
and also delayed puberty which may be the cause for Sean’s short height. The
decision 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 will
determine if the family and patient agree to this treatment after consulting
the doctor. Nonmaleficence is doing no harm in this situation if this treatment
were to cause immediate harm or danger to the patient the nurse would let the
patient and family know about these risks and it would be their decision to
proceed or not, in this case Sean does not want any painful procedures.
Beneficence is promoting good for others, and if this treatment helps with
physical or psychosocial development the nurse would promote the benefits.
Disability: Physiological or psychological consequences to being
short is not a disability, however the child may display psychological
consequences of being short. These may include low self-esteem, the child may start demonstrating poor school performance
and 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 social
anxiety and a lack of confidence because of bullying in school (McKinney et
al., 2013). Economic consequences may
come up in the cost of treatment and adulthood if they cannot preform well in a
job or get a job due to the lack of confidence and feeling intimidated that
their height will always determine how they are treated.
psychosocial benefits and risks of administering growth hormone.
The physical benefits of administering growth hormone is that Sean
will grow 4 inches the first year, then three inches per year for two more years
after the growth rate slows (McKinney et al., 2013). If treatment is started on a younger
child the greater the height potential, and growth hormone therapy typically
continues until the growth plates are closed or until they have reached an
acceptable or predicted final height (McKinney et al., 2013). The risks of
administering growth hormone include behavioral changes, headaches, back pain
(Mayo clinic, 2015). Sean is 6 years old now and his parents have the decision
to go ahead with the procedure. The child should be given the correct
information about a procedure at a developmentally
appropriate format, so he can understand (McKinney et al., 2013). Autonomy could be violated in this case
because Sean has stated he does not want any painful procedures and if the
parents go ahead with this treatment pain is one of the side effects.
In conclusion, the main benefits of the growth hormone
are the child’s psychological development may not be affected because it puts
them at a lesser chance of being bullied for their height. Physically Sean
would begin to grow and be more on track with other children his age. The
parents have the final say of agreeing to the treatment for him. If the parents
agree to the treatment it should begin now since Sean is young and if will be
more beneficial to begin now. The benefits for this treatment weigh out the
risks and starting the growth hormone now will save Sean from any psychological
consequences later in adulthood.