Instructions: Provide complete and concise answers to questions, do not include questions or scenario, and
submit to assigned drop box by deadline. Use scholarly writing for all answers. Include APA style title page,
citations, and reference list. Use correct grammar, complete sentences, paragraph structure, and professional
terms. Use scholarly sources (e.g., textbook, journals, government agencies) less than 5 years old to support
answers. Paraphrase content (i.e., rephrase in your own words), cite/reference source, and do not use quotes.
Part 1: Carter Gibbs is a 72-year old African American male who presents to the emergency department with a
complaint of left wrist pain after falling at home. He was diagnosed with diabetes mellitus type II at age 50. Over
the years, he has developed multiple complications including cardiomyopathy, retinopathy with decreased visual
acuity, chronic kidney disease, and peripheral neuropathy. He has had many previous hospitalizations related to
diabetic, cardiac, and renal complications. The nephrologist has informed him about the likelihood of requiring
dialysis in the near future, but the client has refused to consider any aggressive treatments. The client is
compliant with his oxygen and medications because “they help my breathing”, but does not adhere to diet or
fluid restrictions. He states “In my condition, there are few things left I can enjoy so I eat what I want. I am sick
and tired of people, telling me what I can and can’t’ do”. He has lived his entire life in Louisiana and is a
Southern Baptist who prays regularly, but is no longer able to attend services. He is essentially wheelchair bound
and on supplemental oxygen via nasal cannula. He lives with his adult daughter and her significant other who are
his primary caregivers. Further interviewing reveals that he is left at home alone for long periods of time while
they work; and he injured his wrist when he fell in the kitchen while trying to get something to eat. Upon
inspection; he is unwashed, smells faintly of urine, and has multiple ecchymoses and skin tears visible on both
arms in various stages of healing. He is thin and gets short of breath easily with excessive talking and movement.
For Mr. Carter,
1. Describe 2 ethical-legal dimensions and the nurse’s responsibilities related to the client (10 points)
2. Explain 2 modifications based on client limitations that the nurse should make in order to complete
a safe, effective, and comfortable physical exam (10 points)
3. Discuss 2 potential healthcare referrals for the client and the need/benefit to the client (10 points)
4. Explain 2 potential cultural and/or spiritual considerations related to care for this client (10 points)
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