NR305 Full Course Latest 2017 August

| August 31, 2017

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Week 1: Healthy People Initiative

7979 unread replies.9393 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.

1. What additional information would you like to gather from Maria?

2. What are Maria’s real and potential health risks?

3. Why is Maria’s culture important when obtaining the health assessment?

4. Pick one of Maria’s health risks. What would be one reasonable short-term goal for this risk?

5. 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.

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Week 2: General Survey/Skin/Nutrition

7777 unread replies.9595 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.

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Week 3: Assessment of the Neurological System

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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

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Week 4: Assessment of Cardiac Status

6868 unread replies.9090 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?

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Week 5: Assessment of Respiratory Status

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?

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Week 6: Assessment of the Abdomen and Genitourinary System

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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.

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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?

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Week 8: Rapid Assessment of a Client

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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 August

Family Genetic History Form

NOTE: Please do NOT remove any of the text on this form. Fill it in and submit in its entirety to aid in its grading.Failing to complete this assignment using an adult participant other than yourself will result in a 20% penalty deduction being applied.Thank you.

Your Name: Date:

Your Instructor’s Name:

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.

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 you find that the client is unwilling to answer several questions, you will need to find another client who can provide more information.

Directions: Refer to the Family Genetic History guidelines and grading rubric found in Course Resources to complete the information below. This assignment is worth 150 points.

Type your answers on this form. Click Save as and save the file with the assignment name and your last name, e.g., “NR305_Family_Genetic_History_Form_Smith”.When you are finished, submit theform to theFamily Genetic History Dropbox by the deadline indicated in your guidelines. Post questions in the Q&A Forum or contact your instructor if you have questions about this assignment.

1: Family Genetic History (60 points):

Develop a family genetic history that includes,at a minimum, three generations of your chosen adult’s family, including grandparents, parents, and the adult’s generation. If the adult has any children, include them as the fourth generation. **PLEASE NOTE: This assignment is to reveal the potential impact of the family’s health on the adult participant. You do not need to identify anyone who is not biologically related to the adult except for a spouse or significant other.

You do not need to use symbols, but instead write brief descriptions for each person. Each description should include the following information: first name, birthdate, death date, occupation, education, primary language, and a health summary, including any medical diagnoses. An example is below.

Family Member

Description

Paternal grandfather

First and last initials:

RL

Birthdate:

1921

Death date:

1981

Occupation:

Retired as a coal miner

Education:

6th grade

Primary language:

English

Health summary:

He was diagnosed with chronic lung disease, diabetes, and hypertension. He died from a heart attack.

Paternal grandmother

First and last initials:

ML

Birthdate:

1932

Death date:

1998

Occupation:

House wife

Education:

Does not want to disclose

Primary language:

English

Health summary:

Diagnosed with chronic lung disease from smoking cigarettes. Died from heart failure.

This example points to common problems among this generation on both sides of the family. Consider the implications this would have for the adult participant’shealth if these were that person’s family members.

Complete the family genetic history form below. Indicate if any information is N/A (not applicable) or unknown. Indicate any information the person did not want to disclose by noting “Does not want to disclose.”

*Please note any areas left blank will be considered missing information and will result in loss of points*

Family Member

Description

Paternal grandfather

First and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Paternal grandmother

First and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Father

First and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Father’s siblings (write a brief summary of any significant health issues)

Maternal grandfather

First and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Maternal grandmother

First and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Mother

First and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Mother’s siblings (write a brief summary of any significant health issues)

Adult Participant

First and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Adult participant’s siblings (write a brief summary of any significant health issues)

Adult participant’s spouse/significant other

First and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Adult participant’s children (write a summary for each child, up to four children)

Child #1 first and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Child #2 first and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Child #3 first and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

Child #4 first and last initials:

Birthdate:

Death date:

Occupation:

Education:

Primary language:

Health summary:

2. Evaluation of family genetic history (30 points)

Evaluate the impact of thefamily’s genetic history on your adult participant’s health. For example, if the adult participant’s mother and both sisters have diabetes, hypertension, or cancer, what might that mean for the adult participant’s future health?

3. Planning for future wellness (45 points)

Plan changes based on the evaluation of the adult participant’sfamily’s health history that will promote an optimal level of wellness both now and in the future. Include what information you would provide to the adult participant regarding the results of the family genetic history.

NR305 Week 4 Course Project Milestone 1 Assignment Latest 2017 August

Course Project Milestone #1: Health History Form

Directions: Refer to the Milestone 1: Health History guidelines and grading rubric found in Course Resources to complete the information below. This assignment is worth 200 points, with 10 points awarded for clarity of writing, which means the use of proper grammar, spelling, and medical language.

Type your answers on this form. Click Save as and save the file with the assignment name and your last name, for example, NR305_Milestone1_Form_Smith. When you are finished, submit the form to the Milestone #1 Dropbox by the deadline indicated in your guidelines. Post questions in the Q&A Forum or contact your instructor if you have questions about this assignment.

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.

Note: Failing to complete this assignment using an adult participant other than yourself will result in a 20% penalty deduction being applied.

BIOGRAPHICAL DATA (10 points)

Date:

Initials:

Age:

Date of birth:

Birthplace:

Gender:

Marital status:

Race:

Religion:

Occupation:

Health insurance:

Source of information:

Reliability of source of information:

PRESENT HEALTH HISTORY/ILLNESS (20 points)

Reason for seeking care:

Health patterns:

Health goals:

HEALTH BELIEFS AND PRACTICES (15 points)

Beliefs and practices:

Factors influencing healthcare decisions:

Related traits, habits or acts:

MEDICATIONS (20 points) (Please refer to your assignment guidelines.)

Prescription medications:

Over-the-counter medications:

Herbals:

PAST HISTORY (20 points)

Childhood diseases:

Immunizations:

Allergies:

Blood transfusions:

Major illnesses:

Injuries:

Hospitalizations:

Labor and deliveries:

Surgeries:

Use of alcohol:

Use of tobacco:

Use of illicit drugs:

EMOTIONAL HISTORY (15 points)

Mental, emotional or psychiatric problems:

FAMILY HISTORY (20 points)

Father:

Mother:

Siblings:

Grandparents:

PSYCHOSOCIAL/ OCCUPATIONAL HISTORY (15 points)

Occupational history:

Educational level:

Financial background:

ROLES AND RELATIONSHIPS (15 points)

Significant others:

Support systems:

ETHNICITY AND CULTURE (10 points)

Ethnicity and culture:

Physical and social characteristics that influence healthcare decisions:

SPIRITUALITY (5 points)

Religious and spiritual needs:

SELF-CONCEPT (5 points)

View of self-worth:

Future plans:

REVIEW OF SYSTEMS (20 points) (Please refer to your assignment guidelines and Chapter 4 of your text. This is not a physical examination.)

Skin, hair, nails:

Head, neck, related lymphatics:

Eyes:

Ears, nose, mouth, and throat:

Respiratory:

Breasts and axillae:

Cardiovascular:

Peripheral vascular:

Abdomen:

Urinary:

Reproductive:

Musculoskeletal:

Neurologic:

NR305 Week 6 Course Project Milestone 2 Assignment Latest 2017 August

Course Project Milestone 2: Patient Teaching Plan Guidelines
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 250 points.

Rubric

Click to view and download the NR305 Milestone 2: Patient Teaching Plan 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.
o 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.

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