Tag: Clinical-Nursing

In this Individual Client Health History and Examination assignment, you will be completing a health assessment on an older adult. To complete this assignment, do the following:

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Perform a health history on an older adult. Students who do not work in an acute setting may “practice” these skills with a patient, community member, neighbor, friend, colleague, or loved one. (If an older individual is not available, you may choose a younger individual).

Complete a physical examination of the client using the “Health History and Examination” assignment resource. Use the “Functional Health Pattern Assessment” resource as a guideline to assist you in completing the template.

Document findings of complete physical examination in Situation-Background-Assessment-Recommendation (SBAR) format. Refer to the sample SBAR Template located on the National Nurse Leadership Council website at 
https://www.ihs.gov/nnlc/includes/themes/newihstheme/display_objects/documents/resources/SBARTEMPLATE.pdf
 as a guide.

Document the findings of the physical examination in the assessment worksheet.

Using the “Health History and Examination” assignment resource, provide the physical examination findings summary with planned interventions for the client. Include any community services in the interventions.

APA format is not required, but solid academic writing is expected. Individual Client Health History and Examination Assignment.

This Individual Client Health History and Examination Assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this Individual Client Health History and Examination Assignment assignment to Turnitin.

NRS-434VN-R-Functional-Health-Pattern-Assessment-Student.docx
 
NRS-434VN-R-IndividualHealthHistoryandExaminationAssignment-Student.docx
.

Individual Client Health History and Examination Assignment

Describe A Existing Manual Or Electronic System With Which You Are Familiar. This System Should Be In Use In A Healthcare Context To Support Health Care Administration Or Health Care Delivery.

Assignment description is attached below. should include a data flow diagrams  regarding how the data flows in the proposed system as show in the attachment. word count can be 2000.

Qualitative Study

Background of Study:

Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes?This gap in knowledge is the research problem.

How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem.

Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

Were the purpose and research questions related to the problem?

Method of Study:

Were qualitative methods appropriate to answer the research questions?

Did the author identify a specific perspective from which the study was developed? If so, what was it?

Did the author cite quantitative and qualitative studies relevant to the focus of the study? What other types of literature did the author include?

Are the references current? For qualitative studies, the author may have included studies older than the 5-year limit typically used for quantitative studies. Findings of older qualitative studies may be relevant to a qualitative study.

Did the author evaluate or indicate the weaknesses of the available studies?

Did the literature review include adequate information to build a logical argument?

When a researcher uses the grounded theory method of qualitative inquiry, the researcher may develop a framework or diagram as part of the findings of the study. Was a framework developed from the study findings?

 

Results of Study

What were the study findings?

What are the implications to nursing?

Explain how the findings contribute to nursing knowledge/science. Would this impact practice, education, administration, or all areas of nursing?

Ethical Considerations

Was the study approved by an Institutional Review Board?

Was patient privacy protected?

Were there ethical considerations regarding the treatment or lack of?

Conclusion

Emphasize the importance and congruity of the thesis statement.

Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

Integrate a summary of the knowledge learned.

Use the practice problem and a quantitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Foundations and history of nursing essay

How does knowledge of the foundations and history of nursing provide a context in which to understand current practice? Identify at least three trends in nursing practice from the “Nursing Timeline of Historical Events” media piece. How have these trends influenced your perspective of nursing practice?

Legal or ethical issues essay – psychiatric unit

Read the case study below and answer the following questions:

a.What legal or ethical issues are involved in this scenario?.

b.Can you identify an ethical dilemma at work here?’.

c.What kinds of professional nursing legal standards are in danger of being violated here? .

d.Do you think that Linda could lose her license? How could she avoid this?. .

Linda is a registered nurse in charge of a large psychiatric unit. At any given time her unit houses an average of twenty-two patients with a variety of diagnoses, ranging from drug dependence to acute psychoses. The unit is usually staffed by one registered nurse, two licensed practical nurses, and two nursing assistants. Hospital policy requires that the registered nurse evaluate each patient’s physical and mental status twice per shift, supervise the administration of all psychotropic medication, participate in group activities, supervise the implementation of each patient’s plan of care, and be available to individual patients for one-to-one interaction. There are additional standards that describe the appropriate care for patients who are potentially suicidal: “Patients who are identified as suicidal will be isolated in private rooms and continuously monitored by a registered nurse.”                 On one particular day two of the patients are identified as potentially suicidal, six geriatric patients with dementia need to be fed and ambulated, one patient is exhibiting violent behavior, and all the patients need individual assessment. Linda calls the supervisor for assistance but is told that there is no one available to help her. The reader will no doubt have noticed that in addition to the other duties, Linda is required to simultaneously and continuously monitor two patients in separate rooms- a physical impossibility. Linda tries to meet all of her obligations under these very strict standards, yet while she is answering a question raised by one of her staff members, one of the suicidal patients manages to injure herself attempting to jump out of a window.

Explain the importance of interprofessionals working together in order to provide patient-centered care

Teamwork has always been the mantra of those persons trying to find a better way to reach objectives.  Consider the patient/person that you want to reach a better state of health with; but, more than that, what benefits interaction between the nursing team and other branches of healthcare management to gain an advantage to providing patient-center care.

Enoxaparin (Lovenox) Nursing Implications Question

Before administering medications to a client hospitalized 3 days ago for acute asthma, the nurse compares the morning laboratory results with the admission data.  The nurse should confirm which prescription with the health care provider prior to administration?

Albuterol nebulization every 4 hours

Enoxaparin 40 mg subcutaneously every 24 hours

Methylprednisolone 20 mg intravenously every 6 hours

Potassium chloride 20 mEq/L every 24 hours

Enoxaparin (Lovenox) Nursing Implications Answer and explanation

The corect answer is 2- Enoxaparin 40 mg subcutaneously every 24 hours

Explanation:

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Enoxaparin (Lovenox)
 is a low-molecular-weight heparin anticoagulant administered for prophylaxis of deep venous thrombosis in hospitalized clients.  Bleeding and 
thrombocytopenia
 (platelet count <150,000/mm 3  [150 x 10 9 /L]) are possible complications of anticoagulant therapy.  Heparin-induced thrombocytopenia (HIT) is a serious condition that often develops rapidly, requiring prompt recognition and treatment.  Unlike other drug-induced forms of thrombocytopenia, HIT can result in  arterial or venous thrombosis (eg, stroke, extremity infarction), although the exact association is unknown.  This client’s platelet count (96,000/mm 3  [96 x 10 9 /L]) has dramatically decreased since admission.  The nurse should note this drastic change and question the continuation of the prescription with the health care provider before administering the medication. (Option 1)   Bronchodilators such as albuterol and ipratropium are indicated in acute asthma and chronic obstructive pulmonary disease exacerbations. (Option 3)   Methylprednisolone (Solu-Medrol) is an anti-inflammatory corticosteroid drug indicated for treatment of lung inflammation associated with asthma; the route, dosage, and frequency are correct.  This client’s elevated white blood cell count is likely due to glucocorticoid administration and is an expected effect of corticosteroids. (Option 4)   Potassium chloride is an electrolyte replacement drug and is indicated by the presence of hypokalemia (<3.5 mEq/L [3.5 mmol/L]); the route, dosage, and frequency are correct.  Frequent use of albuterol likely caused hypokalemia in this client. Enoxaparin (Lovenox) Nursing Implications Educational objective: Heparin-induced thrombocytopenia can result in arterial or venous thrombosis.  Platelet counts should be carefully monitored in any client receiving anticoagulant therapy.

Juvenile diabetes (Type I) – childhood diseases that exist in adults essay

In this  assignment, you will be developing a presentation on childhood diseases that exist in adults. To complete this assignment, access the “Collaborative Learning Community: Health Promotion Presentation” resource.

Solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center. APA format.

 

Topic:  Juvenile diabetes (Type I)

 

1. Develop  health screening, promotion, interventions, and education for adults with this condition is accurate and comprehensive, showing evidence of thoughtful reflection.

Septic Shock vs Sepsis Question

A client with diabetes and an infected heel ulcer is transferred to the intensive care unit because of deteriorating condition.  Based on the admission assessment, what does the nurse identify as the 
most likely
 condition?  
Click the exhibit button for additional information
.

Multiple organ dysfunction syndrome (MODS)

Sepsis

Septic shock

Systemic inflammatory response syndrome (SIRS)

Septic Shock vs Sepsis Correct Answer

3-Septic shock

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Septic Shock vs Sepsis Expalnation

The presence of infection with a gram-positive wound culture increases the risk for developing sepsis and septic shock.  
Sepsis-induced hypotension
 despite adequate fluid resuscitation (30 mL/kg) is defined as 
“septic shock.”
  Hypotension and inadequate tissue perfusion (ie, elevated serum lactate level) despite fluid resuscitation and decreased central venous pressure (ie, decreased circulating volume) and pulmonary artery wedge pressure (ie, decreased preload) indicate the presence of septic shock in this client.  Based on the alterations in hemodynamic parameters, septic shock is the most likely condition in this client.

(Option 1)
  MODS is the failure of 2 or more body organs (eg, acute kidney injury, acute respiratory distress syndrome).  Septic shock can progress to multiorgan dysfunction (ie, severe end of sepsis and septic shock).  However, the assessment data do not indicate that it is the most likely condition at this time.

(Option 2)
  
Sepsis
 is a systemic inflammatory response (ie, increased heart rate, respirations, temperature, and decreased systolic blood pressure) to a documented or suspected 
infection
 and is present in this client.  However, it is not the most likely condition because the assessment data support progression along the sepsis continuum to septic shock.

(Option 4)
  
SIRS
 is a generalized inflammatory response to an 
infectious or noninfectious
 insult to the body.  It is often difficult to distinguish from early sepsis.  When SIRS is suspected, a source for sepsis should be sought.

Septic Shock vs Sepsis Educational objective:

SIRS
 → Generalized inflammatory response to an infectious or noninfectious insult to the body

Sepsis
 → Presence (probable or documented) of infection along with systemic manifestations of infection

Septic shock
 → Sepsis-induced hypotension despite adequate fluid resuscitation (30 mL/kg)