NR305 Week 1 Discussion Latest 2017 November
Week 1: Healthy People Initiative
103103 unread replies.103103 replies.
The topic this week asks you to apply what you have learned to the
following case study.
As the school nurse working in a college health clinic, you see
many opportunities to promote health. Maria is a 40-year-old Hispanic who is in
her second year of nursing school. She complains of a 14-pound weight gain
since starting school and is afraid of what this will do to both her appearance
and health if the trend continues. After conducting her history, you learn that
she is an excellent cook and she and her family love to eat foods that reflect
their Hispanic heritage. She is married with two school-age children. She
attends class a total of 15 hours per week, plus she must be present for 12
hours of labs and clinical. She maintains the household essentially by herself
and does all the shopping, cooking, cleaning, and chauffeuring of the children.
She states that she is lucky to get 6 hours of sleep per night, but that is
okay with her. She lives 1 hour from campus and commutes each day. Using
Healthy People 2020 (Links to an external site.)Links to an external site. and
your text as a guide, answer the following questions.
What additional information would you like to gather from Maria?
What are Maria's real and potential health risks?
Why is Maria's culture important when obtaining the health
assessment?
Pick one of Maria's health risks. What would be one reasonable
short-term goal for this risk?
What nursing interventions would you incorporate into Maria's plan
of care to assist her with meeting your chosen goal? Please provide rationale
for your selections.
NR305 Week 2 Discussion Latest 2017 November
Week 2: General Survey/Skin/Nutrition
105105 unread replies.105105 replies.
Your home health agency has received an order from a local
hospital to evaluate and treat an elderly woman being discharged from its
medical surgical unit.
Millie Gardner, an 83-year-old female patient, is being discharged
home today to the care of her husband Fred (87 years old) following a 9-day
hospitalization for pneumonia, dehydration, and failure to thrive. She has a
history of hypertension (HTN), Type II Diabetes, and cerebral vascular accident
(CVA) with left-sided weakness. Patient is alert and oriented but does have
periods of forgetfulness during the overnight hours. Patient has intermittent
incontinence of bowel and bladder and requires assistance with all activities
of daily living (ADLs).
Medications:
- Lopressor
- Lisinopril
- Plavix
- Metformin
- Novolin
R per sliding scale *NEW*
- Multivitamin
- Colace
- Zithromax
*NEW*
Upon arrival you are greeted by Champ, the couple's rambunctious
miniature Doberman pinscher dog. Millie is in her wheelchair staring blankly
out the window, and Fred is busy in the kitchen preparing the couple's lunch.
- Based
on the scenario above, please use the general survey process to describe
the areas that you would be observing immediately upon entry to the home.
- What,
if any, concerns related to Millie's skin and nutritional status do you
have?
- What
nursing interventions will you include in the plan of care to address
these concerns?
- What
teaching strategies will you use to educate Millie and Fred on the new
medications?
- Using
the SBAR, please include the information that you will communicate to the
physician's office at the completion of the visit.
NR305 Week 3 Discussion Latest 2017 November
Week 3: Assessment of the Neurological System
9191 unread replies.9191 replies.
Randy Adams is a 38-year-old male patient of Dr. Joseph Reynolds
who was admitted yesterday morning for 24-hour observation for mild concussion
following a motor vehicle accident. Randy lost consciousness during the
accident and was very confused when he arrived in the ER after EMS transport.
He is an Iraq war veteran and he seemed to think after the accident that this
all happened in Iraq. Dr. Reynolds is concerned that Randy has some residual
problems from a couple of explosive incidents that occurred while he was in
Iraq. The physician is unsure whether Randy's current symptoms are from the car
accident or from prior injuries so he has referred him for consultations to
both a neurologist and to a behavioral health specialist.
Based on the above please discuss the following.
1. Pathophysiology
of concussive injuries and treatment
2. Neurological
assessment tools used in your current practice setting (if not presently
working, please describe one used during prior employment or schooling)
3. Current
best practices associated with post-traumatic stress disorder (PTSD)
4. Nursing
interventions you would include in this patient's plan of care
NR305 Week 4 Discussion Latest 2017 November
Week 4: Assessment of Cardiac Status
9494 unread replies.9494 replies.
Esther Jackson is a 56-year-old black female who is 1-day post-op
following a left radical mastectomy. During morning rounds, the off-going nurse
shares with you during bedside report that the patient has been experiencing
increased discomfort in her back throughout the night and has required frequent
help with repositioning. She states that the patient was medicated for pain
approximately 2 hours ago but is voicing little relief and states that you
might want to mention that to the doctor when he rounds later this morning.
With the patient appearing to be in no visible distress, you proceed on to the
next patient's room for report.
Approximately 1 hour later, you return to Ms. Jackson's room with
her morning pills and find her slumped over the bedside stand in tears. The
patient states, "I don't know what is wrong, I don't feel right. My back
hurts and I'm just so tired. What is wrong with me?" The patient refuses
to take her medications at this time stating that she is starting to feel sick
to her stomach.
Just then the nursing assistant comes into the patient's room to
record Ms. Jackson's vital signs, you take this opportunity to quickly research
the patient's medication record to determine if she has a medication ordered
for nausea. Upon return, the nursing assistant hands you the following vital
signs: T 37, R 18, and BP 132/54, but states she couldn't get the patient's
pulse because "it is all over the place."
Please address the following questions related to the scenario.
1. What do
you suspect is the cause of the patient's symptoms?
2. Describe
the course of action that you will take to confirm this suspicion and prevent
further decline.
3. What
further assessments, lab values, and tests will likely be ordered for this
patient and how often? If testing is to be completed more than once, please
explain the rationale for doing so.
4. While you
are caring for this patient, how will you ensure that the needs of your other
patients are being met?
NR305 Week 5 Discussion Latest 2017 November
Week 5: Assessment of Respiratory Status
100100 unread replies.100100 replies.
Please review the video above as it will provide you with an
opportunity to immerse yourself in the role of a nurse addressing tobacco use
during routine patient care. In doing so, reflect on what you have learned
about tobacco use and the role that nurses and other interdisciplinary team
members play in helping to assist tobacco users with quitting. While viewing,
it is also important to keep in mind that tobacco users move through stages of
change in the process of quitting. They move from pre-contemplation to
contemplation, contemplation to preparation; preparation to abstinence;
abstinence to maintenance. Every stage requires a different strategy by a
nurse.
After watching the video, and reflecting on the information
presented, address each of the following questions.
1. What are
the common symptoms associated with an exacerbation of COPD?
2. What
assessment techniques will you use to assess Mary?
3. Identify
smoking strategies that would be appropriate for each of the encounters that
Mary had with the nurse throughout the video that could have been used to
assist Mary in quitting smoking.
4. Find a
resource in your community that could assist Mary. Start by searching the
Internet for your local health department's website. What services are
available to Mary? Briefly describe the services that the state quit line
provides. Does it meet the 4 As? Is it accessible, acceptable, affordable, or
available for Mary?
5. What will
you do to follow-up on Mary's smoking cessation process?
NR305 Week 6 Discussion Latest 2017 November
Week 6: Assessment of the Abdomen and Genitourinary
System
8686 unread replies.8686 replies.
Amira is a 27-year-old Syrian refugee who has been residing in a
local homeless shelter since her arrival here in the United States 4 weeks ago.
She was brought into the emergency room this morning via squad after being
found by a shelter employee sitting in a pool of blood on the bathroom floor
crying and holding her abdomen. Due to her limited English speaking abilities,
she is unable to provide specific details as to her complaints but the shelter
employee states that she has recently stopped eating and has not looked well
for the past couple of days.
Based on the limited information provided, please answer the
following questions.
1. How will
you prioritize your care of Amira, what assessments will you complete, and in
what order? Please provide rationale for choosing this order.
2. Are there
any cultural beliefs/practices that must be taken into consideration when
planning her care?
3. Considering
her symptoms of abdominal pain and bleeding, is it possible that her status as
a homeless refugee is a causative or contributing factor to her illness? Please
provide rationale for your response.
NR305 Week 7 Discussion Latest 2017 November
Week 7: Assessment of the Musculoskeletal System and
Pain
8181 unread replies.8181 replies.
Fred is an 83-year-old male who is being admitted to the
medical-surgical unit status post fall. He is alert and oriented and reports
that while visiting a local casino with his wife Margaret earlier this evening,
he tripped over a curb and fell landing on his right side. After receiving
morphine in the emergency room prior to transfer to your unit, Fred is rating
his pain at 6/10. He has multiple bruises from his jawbone to his knee as well
as a slight rotation of his right leg.
Past medical history includes: myocardial infarction (MI) x 2,
peripheral vascular disease (PVD) with bilateral iliac stents,
non-insulin-dependent diabetes mellitus (NIDDM), sleep apnea, and degenerative
joint disease.
Medications include: aspirin, Plavix, Lopressor, Lisinopril, and
Metformin.
After reviewing the above scenario please answer the following
questions.
1. Based on
the information provided, how will you prioritize your care, what assessments
will you include and in what order? Please provide rationale for your response.
2. Considering
this patient's age, injury, past medical history, and list of current
medications, what, if any, concerns do you have related to his potential need
for surgery?
3. Should
surgery to repair his right femur be required; what type of clearance and
pre-op orders would you anticipate receiving related to his diet, meds, lab
work, and so on?
NR305 Week 8 Discussion Latest 2017 November
Week 8: Rapid Assessment of a Client
7878 unread replies.7878 replies.
Please choose one of the patient scenarios below. Next, complete a
rapid assessment, and provide a SBAR report to a classmate. Remember to include
all concepts of patient safety, standard precautions, and professional
standards.
1. You are
covering for a coworker who is off the floor for lunch, when you suddenly hear
a loud crash coming from a nearby patient room. You quickly run in and discover
Mr. Johnson who was admitted yesterday with a diagnosis of cerebral vascular
accident (CVA) unconscious on the floor between the bed and the bathroom.
2. You are
called to the room of 2-year-old Jonah by his mother who states the child has
suddenly started breathing very loudly and does not look right. Upon entering
the room you quickly recognize that the child is in respiratory distress as his
lips are cyanotic and the use of accessory muscles is evident.
3. You are
in the process of admitting Ashley, a 27 year old who is 28 weeks pregnant with
her first child, to the obstetric unit for complaints of headache, dizziness,
and swelling of her lower extremities when she suddenly begins seizing.
NR305 Week 2 Family Genetic History Assignment Latest
2017 November
Family Genetic History Guidelines
Purpose
This assignment is to help you gain insight regarding the
influence of genetics on an individual's health and risk for disease. You are
to obtain a family genetic history on a willing, nonrelated, adult participant.
NOTE: failing to complete this assignment using an adult participant other than
yourself will result in a 20% penalty deduction being applied.
Course Outcomes
This assignment enables the student to meet the following Course
Outcomes.
CO #3: Utilize effective communication when performing a health
assessment. (PO #3)
CO #5: Explore the professional responsibilities involved in
conducting a comprehensive health assessment and providing appropriate
documentation. (PO #6)
Points
This assignment is worth a total of 150 points.
Due Date
The Family Genetic History Assignment is to be submitted at the
end of Week 2. Click to download the Family Genetic History form (Links to an
external site.)Links to an external site.. You must fill in and submit by 11:59
p.m. MT at the end of Week 2. Post questions to the weekly Q & A Forum.
Contact your instructor if you need additional assistance. See the Course
Policies regarding late assignments. Failure to submit your paper on time may
result in a deduction of points.
Disclaimer
When taking a family genetic history on an actual client, it is
essential that the information is accurate. Please inform the person you are
interviewing that they do not need to disclose information that they wish to
keep confidential. If the adult participant decides not to share information,
please write, "Does not want to disclose." If the client fails to
disclose answers to several items, you will need to find another client who is
willing to share.
Directions
Refer to the examples in Chapter 4 of your textbook that discuss
development of a genogram.
Download the NR305_Family_Genetic_History_Form (Links to an
external site.)Links to an external site.. You will document the adult
participant's family genetic history using this MS Word document.
Complete the family genetic history using the information that the
adult participant is willing to share with you. The focus of this course is on
the normal healthy individual so your paper does not need to contain much
medical/nursing detail. Refer to your textbook or the Internet to learn what
impact the family's health history may have on the adult participant's personal
state of wellness both now and in the future. This paper does not require APA
formatting, but you are expected to write clearly and use proper grammar and
spelling. Developing a pictorial genogram using symbols to identify certain
relationships (e.g., divorced, sibling, deceased, etc.), may provide more
insight, however, drawing may be difficult to accomplish with MS Word,
therefore you are not expected to use symbols, lines, or other drawing
elements. Instead, describe the relationships among the various people in the
adult participant's family's genetic history. Remember, the goal is not to
learn how to draw with Word, but to gather information about the family and recognize
its significance to the adult participant and that person's health.
Save the completed form by clicking on Save as and add your last
name to the file name, for example, NR305_Family_Genetic_History_Form_Smith.
Submit the completed form to the Family Genetic History form by
Sunday, 11:59 p.m. MT at the end of Week 2. Please post questions about this
assignment to the weekly Q & A Forums so the entire class may view the
answers.
NR305 Week 4 Course Project Milestone 1 Latest 2017
November
Course Project Milestone 1: Health History Guidelines
Updated 9/22/2017
Purpose
The student will obtain a health history on a willing, nonrelated,
adult participant in order to generate written documentation that is clear and
accurate. Note: Failing to complete this assignment using an adult participant
other than yourself will result in a 20% penalty deduction being applied.
Course Outcomes
This assignment enables the student to meet the following Course
Outcomes.
CO #3: Utilize effective communication when performing a health
assessment. (PO #3)
CO #4: Identify teaching/learning needs from the health history of
an individual. (PO #2)
CO #5: Explore the professional responsibilities involved in
conducting a comprehensive health assessment and providing appropriate documentation.
(PO #6)
Points
This assignment is worth a total of 225 points.
Due Date
The Course Project Milestone 1: Health History assignment is to be
submitted by Sunday, 11:59 p.m. MT at the end of Week 4. Post questions to the
Q & A Forum. Contact your instructor if you need additional assistance.
Disclaimer
The focus of this assignment is on communicating details within
the written client record. When taking a health history on an actual client, it
is essential that the information is accurate. Please inform the person you are
interviewing that they do not need to disclose information that they wish to
keep confidential. If the interviewee decides not to share information, please
write, "Does not want to disclose." If the client fails to disclose
answers to several items, you will need to find another client who is willing
to share.
Directions
Find an adult who is not related to you who is willing to let you
take a health history.
Download the NR305_Milestone1_Form (Links to an external
site.)Links to an external site.. You will type your answers directly into this
Word document. Your paper does not need to follow APA formatting; however, you
are expected to be clear in your communication by using correct medical
terminology, grammar, and spelling.
Review the examples in Chapter 4 of your textbook to gain insight
into how to document the health history. Remember this is a health history, not
a physical examination. Avoid words like frequently, improved, increased,
decreased, good, poor, normal, or WNL as they may have different meanings for
different people. Instead, document the specific data that led you to these
conclusions, for example, 3x/day instead of frequently, or consuming four
servings of vegetables/day instead of increased vegetable servings.
Save the file by clicking Save as and adding your last name to the
file name, for example, NR305_Milestone1_Form_Smith.
Submit the completed form by Sunday, 11:59 p.m. MT at the end of
Week 4.
Please post questions in the Q & A Forum so the entire class
may view the answers.
NR305 Week 6 Course Project Milestone 2 Latest 2017
November
Course Project Milestone 2: Patient Teaching Plan Guidelines
Updated 9/22/2017
Purpose
The purpose of this PowerPoint presentation is to apply
information gathered from the Family Genetic History and Milestone 1
assignments to aid with identifying one modifiable risk factor and develop an
evidence-based teaching plan that promotes health as well as improves patient
outcomes.
Course Outcomes
This assignment enables the student to meet the following Course
Outcomes.
CO #4: Identify teaching/learning needs from the health history of
an individual. (PO #2)
Points
This assignment is worth a total of 225 points.
Rubric
Click to view and download the Milestone 2 Grading Rubric (Links
to an external site.)Links to an external site..
Due Date
The assignment is to be submitted by Sunday, 11:59 p.m. MT at the
end of Week 6. Post questions to the Q & A Forum. Contact your instructor
if you need additional assistance. See the Course Policies regarding late
assignments. Failure to submit your assignment on time may result in a
deduction of points.
Directions
Prepare a patient teaching plan for your participant based on the
information you discovered in your previous assignments. Present your plan
using Microsoft PowerPoint.
Title slide (first slide): Include a title slide with your name
and title of the presentation.
Introduction/Identification (two to three slides): Introduce a
modifiable risk factor (diet, smoking, activity, etc.) that will be the focus
of your presentation.
Identify at least one important finding you discovered in
Milestone 1 that is associated with this risk factor.
Explain how this places your adult participant at increased risk
for developing a preventable disease (obesity, Type II Diabetes, etc.), which
is described.
List short and long-term goals.
Intervention (four to five slides):Choose one evidence-based
intervention related to the modifiable risk factor chosen that has been shown
to be effective at reducing an individual's risk for developing the preventable
disease.
Describe the intervention in detail.
Provide rationale to support the use of this intervention. Support
your rationale with information obtained from one scholarly source as well as
Healthy People 2020 ( http://healthypeople.gov (Links to an external
site.)Links to an external site.). Include any additional resources (websites,
handouts, etc.) that you will share with your adult participant, if applicable.
Evaluation (three to four slides): Describe at least one
evaluation method that you would use to determine whether your intervention is
effective. Outcome measurement is a crucial piece when implementing
interventions.
Describe at least one method (weight, lab values, activity logs,
etc.) you would use to evaluate whether your intervention was effective.
Describe the desired outcomes you would track that would show
whether your intervention is working.
Include additional steps to be considered if your plan proved to
be unsuccessful.
Summary (one to two slides): Reiterate the main points of the
presentation and conclude with what you are hoping to accomplish as a result of
implementing the chosen intervention.
References (last slide): List the references for sources that were
cited in the presentation.
Speaker notes: Share in detail how you would verbalize the content
on each of the slides to the patient.
Remember, you are creating a patient teaching plan so be sure to
include terms easily understood by the general population and limit your use of
medical jargon. Slides should include the most important elements for them to
know in short bullet-pointed phrases. You may add additional comments in the
notes section to clarify information for your instructor.
Guidelines
Application: Use Microsoft PowerPoint 2010 (or later).
Length: The PowerPoint slide show is expected to be no more than
14 slides in length (not including the title slide and References list slide).
Submission: Submit your file by 11:59 p.m. Sunday end of Week 6.
Save the assignment with your last name in the file's title:
Example: Smith Patient Teaching Plan.
Late Submission: See the Policies under Course Home on late
submissions.
Tutorial: For those not familiar with the development of a
PowerPoint slideshow, the following link to the Microsoft website may be
helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx
(Links to an external site.)Links to an external site. The Chamberlain Student
Success Strategies (CCSSS) offers a module on Computer Literacy that contains a
section on PowerPoint.
Best Practices in Preparing PowerPoint
The following are best practices in preparing this presentation.
Be creative.
Incorporate graphics, clip art, or photographs to increase
interest.
Make easy to read with short bullet points and large font.
Review directions thoroughly.
Cite all sources within the slides with (author, year) as well as
on the Reference slide.
Proofread prior to final submission.
Spell check for spelling and grammar errors prior to final
submission.
Abide by the Chamberlain academic integrity policy.
