NUR2571 Full Course latest 2018 july

Module 1 discussion

Clinical Judgment

Clinical Judgment is the process of integrating evidence-based practice, critical-thought, the Nursing Process, knowledge, skills, and attitudes, as well as application of theory to practice in order to promote safe, quality care to clients in all settings.

Keeping that in mind, answer the following scenario:

You are the Charge Nurse in a large Urban Emergency Department (ED). You nursing staff include:

RN with 12 years of Trauma ED experience

New RN with 6 months ED experience

RN from the Medical Surgical floor with 8 years of experience

The following patients are in the ED, which patient will you give to each of the nurses and why?

A 76-year-old client who was involved in a motor vehicle accident and has hematuria.

A 38-year-old client with kidney stones complaining of severe pain.

A 24-year-old diabetic client with an acute urinary tract infection who will require discharge teaching.

An 80-year-old client that has not had a bowel movement for 4 days.

Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Module 2 discussion

Patient with Hyperkalemia

Mr. Sweet, 38 years old, is brought to the Emergency Department unresponsive. He has a history of Type 1 diabetes and has been sick for the last 3 days. On admission his Blood sugar is 532, Potassium is 7.2 and ABG results include pH 7.08, Bicarb 12, and CO2 28. His VS are HR 116, BP 107/64, RR 36 Deep and rapid, and Temp 101.5. Answer the following questions:

What interventions do expect to be ordered for Mr. Sweet? Why?

What type of acid-base disturbance does he have?

What do you think is Mr. Sweet's Medical Diagnosis?

Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation

Module 3 discussion

Case Scenario: Tuberculosis

Wilson is a 36-year-old migrant worker. He was admitted to the Hospital with a cough, unintended weight loss, and night sweats. He is staying with 6 friends in a one bedroom apartment near the strawberry field where he works. The ED physician suspects Tuberculosis (TB).

What diagnostic testing will the Provider order to confirm a diagnosis of TB?

What Isolation precautions do you expect to be put in place and why?

Describe the recommended treatment regimen for TB, including the rationale for combination drug therapy.

Identify the reason compliance to medication therapy is often a concern in the patient with TB.

What should be done for Wilson's 6 roommates?

Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Module 4 discussion

I-SBAR-R Reporting

Think of a situation from clinical when the Provider needed to be informed of a change in patient condition. Using ISBARR write what you would report to the Provider. You can use the ISBARR form for guidance.

Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Module 5 discussion

Patient Teaching: Anticoagulants

Sandra is a 27-year-old female admitted with a possible Deep Vein Thrombosis (DVT). She smokes one pack per day and is on birth control. She has a history of hypertension and obesity. She is admitted to the hospital and placed on bedrest. Heparin drip is started per protocol. The Provider is anticipating on sending her home with Coumadin.

Can Sandra be placed on Coumadin and Heparin at the same time? Explain your answer.

Develop 3 teaching points important for Sandra to know about her medications regimen.

Teach Back is a great way to find out about patient teaching effectiveness. Watch the following video for an example of Teach Back

What questions would you ask Sandra to verify that she understand the 3 teaching points?

Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Module 7 discussion

Type 1 vs. Type 2 and Patient Education

Compare and contrast risk factors, age of onset, pathophysiology and clinical manifestations of Type 1 and Type 2 Diabetes. What do you think is the most important topic that must be taught to the diabetic patient and why?

Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Module 8 discussion

The Older Adult

A nurse at the local Senior Center made the following notation about a client: A 74-year-old female client wearing eyeglasses with bifocal lenses and hearing aid in her left ear. Walks with a shuffling gait, using a cane for support. Wearing house slippers and housedress. States, "My other doctor says I should have my eyes looked at by an expert. It's been a while, and my eyes seem to be acting up lately. I can't see so good anymore." The client states that she takes medication for "sugar" and her blood pressure and has worn glasses for years with the last prescription changed about 3 years ago. "I was a seamstress for many years and quit when I couldn't see to thread the needles anymore-just in time too. These new materials are too hard to work with!" Denies using any eye drops. Describes vision changes as difficulty seeing well at night, especially if trying to read. Uses a magnifying glass to help when reading. No eye pain or discharge, although eyes sometimes feel "dry and scratchy," with the left eye being worse than the right. Admits to rubbing eyes but without relief.

Develop a Plan of Care for this patient that includes:

2 Nursing Diagnosis

2 goals for each Nursing Diagnosis

Interventions with rationales

Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Module 10 discussion

Bariatric Surgery Patient

EJ is a 28-year-old female. She is being admitted for Gastric Bypass Surgery. She is 5'6'' and 265 pounds. She has a history of Diabetes and hypertension, she is not on medications at the time.

What client education topics are important to reinforce for this client?

How will this client's diet be advanced?

What complications can occur after this surgery?

What is Dumping Syndrome and what are some interventions to help prevent its development?

Please make an initial post by midweek, and respond to at least two other student's posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Module 01 Written Assignment - Bowel and Urinary Disorders

Complete the comparison tables on urinary disorders and bowel disorders.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Comparison of Urinary Elimination Disorders:

	Stress Incontinence	Benign Prostatic Hypertrophy	Pyelonephritis
Pathophysiology
Etiology
Clinical Manifestations
Interventions

Comparison of Bowel Elimination Disorders:

	Diarrhea	Bowel Obstruction	Hemorrhoids
Pathophysiology
Etiology
Clinical Manifestations
Interventions

Module 02 Written Assignment - Fluid/electrolyte disturbances and ABG interpretation

Complete the Fluid disturbance table and answer the following ABGs (Arterial Blood Gases).

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Comparison of Fluid Deficit and Fluid Overload

a	Fluid Deficit	Fluid Overload
Definition
Causes/Risk Factors
Clinical Manifestations (including laboratory data)
Collaborative Management (Interventions)

Interpret the following Arterial Blood Gases

1. pH 7.33 PaCO2 60 HCO3 34

A. Normal ABG values

B. Respiratory acidosis without compensation

C. Respiratory acidosis with partial compensation

D. Respiratory acidosis with full compensation

2. pH 7.48 PaCO2 42 HCO3 30

A. Metabolic acidosis without compensation

B. Respiratory alkalosis with partial compensation

C. Respiratory alkalosis with full compensation

D. Metabolic alkalosis without compensation

3. pH 7.38 PaCO2 38 HCO3 24

A. Respiratory alkalosis

B. Normal

C. Metabolic Alkalosis

D. None of the above

4. pH 7.21 PaCO2 60 HCO3 24

A. Normal

B. Respiratory acidosis without compensation

C. Metabolic acidosis with partial compensation

D. Respiratory acidosis with complete compensation

5. pH 7.48 PaCO2 28 HCO3 20

A. Respiratory alkalosis with partial compensation

B. Respiratory alkalosis with complete compensation

C. Metabolic alkalosis without compensation

D. Metabolic alkalosis with complete compensation

Module 02 Course Project-Clinical Question

Clinical Question - Formulate a clinical question using the PICOT format.

P: Patient Population

I: Intervention or area on Interest

C: Comparison intervention or group

O: Outcome

T: Time

Ex: "In acute care hospitals (patient population), how does having a rapid response team (intervention) compared with not having a response team (comparison) affect the number of cardiac arrests (outcome) during a three-month period (time)?"

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Module 03 Written Assignment - Respiratory Disease

Complete the Respiratory Diseases comparison table.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Comparison of Respiratory Disorders:

	Asthma	Emphysema	Chronic Bronchitis	Pneumonia
Pathophysiology
Etiology/Population at Risk
Clinical Manifestations including Laboratory data
Typical Nursing Diagnosis
Interventions

Module 04 Written Assignment - Concept Map-Hypertension

Develop and Concept Map, using the form provided, on the following patient. Include Diagnostic data and medical orders that you expect to be ordered on the patient.

T.J., a 30-year-old African American client, is in his last year of law school and is clerking for a prestigious law firm. He and his fiancé plan to marry as soon as he graduates. During the last week he has had four dizzy spells and a headache at the base of his skull upon awakening for the last 2 days. His father has a history of hypertension, so T.J. is aware that his symptoms may indicate high blood pressure. On his way home from work, T.J. stops by the clinic and asks the nurse to check his blood pressure. The nursing assessment yields the following data.

Subjective data: States he has had four dizzy spells and has awakened with a headache in the occipital lobe the last two mornings. T.J. has 1 glass of wine at lunch and 2-3 beers in the evening to relax from the tension of school and work. Most of his meals are at fast-food establishments and have a high fat content. T.J. does not smoke. He used to jog 4 mornings a week but quit when he started clerking. He has had nocturia for the last 3 weeks. He is not taking any medication. T.J. states he is concerned about having hypertension because he does not want to take medication.

Objective data: T 98.6°F(37°C), AP 78 beats/min, R 16 breaths/min, BP 142/92 mm Hg, Wt 190 lbs (optimum weight 160). No edema noted in hands, feet, or legs.

Possible Medications

Possible Nursing Diagnosis

Medical Diagnosis

Patient Data/Risk Factors

Pathophysiology

Medical Interventions

Diagnostic Data

Patient Education

Nursing Interventions

Clinical Manifestations Subjective: Objective:

Module 04 Course Project -Reference Page

Turn in a reference page in APA format. You must use three (3) or more relevant sources; to ensure the readings are relevant and current, the selected peer reviewed article must have been written within the past three (3) years.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Module 05 Written Assignment - Medications affecting Coagulation

Please go through and fill out the table on Medications affecting Coagulation. If need be go back on previous lectures or your textbook for resources to help you complete the assignment.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Module 06 Written Assignment - Inflammatory Diseases

Complete the comparison table for Inflammatory Diseases.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Comparison of Inflammatory Disease:

	Rheumatoid Arthritis	Systemic Lupus Erythematosus	Ulcerative Colitis
Pathophysiology
Etiology
Clinical Manifestations
Common Laboratory Tests
Treatment

Module 07 Written Assignment - Acute Complications of Diabetes

Fill out the Table comparing the Acute Complications of Diabetes.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Comparison of Acute Complications of Diabetes:

	Hypoglycemia	Diabetic Ketoacidosis	Hyperosmolar Hyperglycemic Nonketotic syndrome
Clinical Manifestations
Diagnostic Data
Interventions
Patient Teaching

Module 07 Course Project-Paper Submission

Your paper for the course project should be a 2-3 page APA paper (not including title page and the reference page) that describes the clinical problem and the following:

Reason for choosing this topic

The PICOT question

Possible integration of the evidenced that you found in clinical practice

Methods to evaluate the effectiveness of implementation

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Module 08 Written Assignment - Otitis Media

An 8-year-old girl comes to your ambulatory care clinic with complaints of left ear pain for the past 3 days. She had respiratory infection a week ago. On physical examination, the tympanic membrane is bulging.

Answer the following questions:

What else should you ask the client?

What teaching would you reinforce to prevent the recurrence of otitis media?

What expected outcomes would be specific to this situation?

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Module 09 Written Assignment – Seizures

An older client was recently discharged from the hospital for evaluation of seizure activity. His history reveals that he has late-stage Alzheimer's disease, Parkinson's disease, hypertension, and type II diabetes mellitus, which is controlled by diet. He lives at home, where his wife and daughter take care of him. His discharge medications include phenytoin (Dilantin), 100 mg BID; hydrochlorothiazide (HydroDIURIL), 50 mg QD; levodopa (Sinemet), 25/100 TID; and haloperidol (Haldol), 1 mg before bed. The client has been referred for home care nursing follow-up.

Questions:

On the initial home visit by the nurse, what assessments should be made?

The wife and daughter need teaching about his antiepileptic medication. What teaching should be included?

During the initial home visit, the client experiences a generalized seizure. What action should the nurse take?

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Module 10 Written Assignment – Exemplars

Fill out the Alteration in Metabolism Exemplar Table.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Alterations in Metabolism

	Obesity	Hyperthyroid	Hypothyroid
Pathophysiology
Risk Factors
Assessment Findings (including Labs)
Possible Nursing Diagnosis
Interventions (including Medications)

Module 10 Course Project - Staff Development PowerPoint Due

Your staff development PPT presentation will include the information from your written paper in 10-12 slides (including a title and reference slide in APA format). Make sure to include speaker notes at the bottom of your slide to explain the content of your slide.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Module 2 quiz

Question 1 A client’s urinalysis results show a protein level of 1.8 mg/dL. Which action by the nurse is best?

Question 2 Which question best assists the nurse in assessing a client with acute diarrhea?

Question 3 Which client statement indicates a good understanding regarding antibiotic therapy for recurrent urinary tract infections?

Question 4 A client with severe bacterial cystitis is prescribed cefadroxil (Duricef) and phenazopyridine (Pyridium). What statement by the client indicates an accurate understanding of these medications?

Question 5 A client just experienced an episode of reflux with regurgitation. What assessment by the nurse is the priority?

Question 6 The nurse is caring for a client who has just returned from abdominal surgery. When auscultating the client’s abdomen, the nurse does not hear any bowel sounds. Which is the nurse’s best action?

Question 7 A client scheduled for intravenous urography informs the nurse of the following allergies. Which one does the nurse report to the health care provider immediately?

Question 8 The female client’s urinalysis shows all the following results. Which does the nurse document as abnormal?

Question 9 The nurse is caring for a client with an umbilical hernia who reports increased abdominal pain, nausea, and vomiting. The nurse notes high-pitched bowel sounds. Which conclusion does the nurse draw from these assessment findings?

Question 10 The client is scheduled for a colonoscopy. Which statement indicates that the client needs additional teaching about the procedure?

Module 5 quiz

Question 1

A client is taking triamterene-hydrochlorothiazide (Dyazide) and furosemide (Lasix). What assessment finding requires action by the nurse?

Question 2

The nurse is teaching a client with pneumonia ways to clear secretions. Which intervention is the most effective?

Question 3

The nurse is caring for a client with newly diagnosed hypertension. What statement by the client indicates adequate understanding of his or her diet restrictions?

Question 4

What information about nutrition does the nurse teach a client with chronic obstructive pulmonary disease (COPD)? (Select all that apply.)

Question 5

A client with systolic dysfunction has an ejection fraction of 38%. The nurse assesses for which physiologic change?

Question 6

The nurse is assessing a client who reports claudication after walking a distance of one block. The nurse notes a painful ulcer on the fourth toe of the client’s right foot. What condition do these findings correlate with?

Question 7

The nurse is caring for four clients with asthma. Which client does the nurse assess first?

Question 8

The nurse is assisting the hospitalized client with his food selections for breakfast. The client is on a low-cholesterol diet. What recommendations are most appropriate for this client?

Question 9

Which statement indicates that the client understands teaching about the use of long-acting beta2 agonist medications?

Question 10

The nurse is assessing clients on a cardiac unit. Which client does the nurse assess most carefully for developing left-sided heart failure?

Module 8 quiz

Question 1

When the nurse is caring for a patient whose HIV status in unknown, which of these patient exposures is most likely to require postexposure prophylaxis?

Question 2

Which information will the nurse include when teaching range-of-motion exercises to a patient with an exacerbation of rheumatoid arthritis?

Question 3

The nurse obtains the following information about a patient before administration of metformin (Glucophage). Which finding indicates a need to contact the health care provider before giving the metformin?

Question 4

A patient is admitted with diabetic ketoacidosis (DKA) and has a serum potassium level of 2.9 mEq/L. Which action prescribed by the health care provider should the nurse take first?

Question 5

A patient hospitalized with an acute exacerbation of ulcerative colitis is having 14 to 16 bloody stools a day and crampy abdominal pain associated with the diarrhea. The nurse will plan to

Question 6

Which nursing action will the nurse include in the plan of care when admitting a patient with an exacerbation of inflammatory bowel disease (IBD)?

Question 7

A pregnant woman with a history of early chronic HIV infection is seen at the clinic. Which information will the nurse include when teaching the patient?

Question 8

Which of these laboratory values, noted by the nurse when reviewing the chart of a hospitalized diabetic patient, indicates the need for rapid assessment of the patient?

Question 9

A 24-year-old woman who uses injectable illegal drugs asks the nurse about preventing AIDS. The nurse informs the patient that the best way to reduce the risk of HIV infection from drug use is to

Question 10

Prednisone (Deltasone) is prescribed for a patient with an acute exacerbation of rheumatoid arthritis. Which laboratory result will the nurse monitor to determine whether the medication has been effective?