Nursing

Assessing: Evaluation of Marginalized Women
Assessing: Evaluation of Marginalized Women
Evaluation of Marginalized Women Guidelines & Grading Rubric
PURPOSE
The purpose of this assignment is to
• Provide learners with the opportunity to integrate knowledge and skills learned throughout this course
• Directly apply principles and knowledge learned in the course to problem solving of population health problems in marginalized women.
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes:
1. Integrate current evidence based clinical practice guidelines in the care of childbearing and childrearing families.
2. Appropriately apply anticipatory guidance and health promotion in the care of childbearing and childrearing families.
3. Assess growth and developmental milestones in the care of childbearing and childrearing families.
4. Construct an evidence based reproductive health management plan.
5. Identify and address healthcare needs of marginalized childbearing and childrearing families
DUE DATE
Submit by Sunday 11:59 p.m. MT at the end of Week 5
TOTAL POINTS POSSIBLE: 150
REQUIREMENTS
This paper should clearly and comprehensively identify the disease or population health problem chosen. The problem must be an issue in your geographic area and a concern for the population you will serve upon graduation with your degree. The paper should be organized into the following sections:
1. Introduction with a clear presentation of the marginalized group as well as significance and a scholarly overview of the paper.
2. Background of the marginalized group/problem including description, current incidence and/or prevalence statistics current state, local, and national statistics pertaining to the problem.
3. Discuss the economic aspects of the marginalized group
4. Discuss social justice and its relationship to health disparities and health care of marginalized group.
5. Discuss ethical issues on marginalized group
6. Provide a brief plan of how you will address this marginalized group in your practice once you are finished with school. Provide three actions you will take along with how you will measure outcomes of your actions.
7. Conclude in a clear manner with a brief overview of key points of the entire problem
PREPARING THE PAPER
Choose one topic from the following list:
• Female Veterans
• Incarcerated Women
• Lesbians
• Transgender Women
• Women with HIV
• Women Sex Workers
• Women with Mental Illness
• Women Immigrants
• Women with Past Sexual Assault
Paper Length: 5-6 pages, excluding title/cover and reference pages
APA format 6th edition
DIRECTIONS AND GRADING CRITERIA
Category Points
Possible Points Earned Comments
Scholarly Introduction (clear presentation of marginalized group) 20
Background and significance of the marginalized group (includes incidence or prevalence statistics) 20
Socio-Economic aspects of the marginalized group 20
Social justice and its relationship to health disparities and health care of marginalized group 20
Ethical issues of the marginalized group 25
Plan of action (includes at least three evidenced based actions, supported by literature, that the student will take in their own practice and how outcomes will be measured) 30
Conclusion 10
Mechanics of writing, APA 5
Total 150 Total Points earned =
A quality paper will meet or exceed all of the criteria requirements.

Assignment: Non-nursing Theories
Assignment: Non-nursing Theories
Week 6 discussion
Borrowed (non-nursing) Theories Applied to the Nursing Profession
While the focus of this course is nursing theory, frequently the use of non-nursing or borrowed theories occurs. Identify your future nursing practice area. Discuss how a specific non-nursing (borrowed) theory has been or could be applied by nurses (specific to practice focus) to effectively deal with an issue. Be sure to provide an example of how the non-nursing theory can be used to enhance the selected practice area. Remember to include scholarly reference(s) to support your information.
Potential discussion topic focus areas:
Nurse educator practice issues: student retention, faculty preparation, critical thinking skills.
Nurse leaders or nurse managers – administrative issues: staffing, use of supplies, staff performance.
Family nurse practitioner – clinical practice issues: chronic illness, aging population, social determinants of health.
Healthcare policy practice issues – environmental health, healthy nurse initiative, childhood obesity.
Nursing informatics practice issues – ergonomics, project management, staff development
Question 2
The Value of a Master’s-Prepared Nurse
Consider the current healthcare delivery models and practice settings. Reflect on how nursing practice is transforming in response to the current demands of the healthcare system and answer one of the following questions:
What differentiates the practice of a master’s-prepared nurse compared to that of a baccalaureate-prepared nurse?
What is the value of a master’s degree in nursing?
What do you consider to be the most essential professional competency for a master’s-prepared nurse practicing in the 21st century?
Refer to AACN Essentials, NLN competencies, and CCN Nursing Conceptual Framework. Use at least one outside scholarly article to support your position. Provide an example to illustrate an application to professional practice.
Week 2 discussion
Caring Concepts in Nursing
This week’s topic is centered on the concept of caring in contemporary nursing practice. In your initial response, provide a definition of caring that aligns with your perspective on the concept of caring. Identify your selected program of study specialty track (Executive, Education, FNP, Healthcare Policy, or Nursing Informatics). Describe how you will apply the principles of caring and holistic nursing in your future professional practice. Use at least one outside scholarly article to support your position. Provide an example to illustrate an application to professional practice.
Week 3 discussion
Knowing Self
Reflect the concepts addressed in this week’s lesson plan and required reading. Recall a challenging experience in either your personal or professional life. In the initial response, start with an introduction that includes a brief description of two core values that influence your nursing practice and interaction with others. Provide a concise description of the challenging experience. What core values were challenged in this experience? What lessons were learned from this experience? How did the experience inform future professional behaviors, decisions, and actions? Provide a specific example on how lessons learned from the challenging experience were applied in your professional practice. Use at least one outside scholarly reference to support your position.
Week 4 discussion
Leadership: Establishing Relationships and Influencing Change
This week’s focus is on developing foundational interpersonal skills that will prepare you for professional practice as a leader and change agent. As a leader, how will you influence change in your professional specialty area? Identify two strengths you have that will promote strong leadership. Identify two areas of improvement to your skill in leading and influencing change. What are two priority strategies you will implement to improve and/or enhance your leadership skills?
Week 5 discussion
Evidence-Based Practice
Discuss the EBP process and importance to nursing practice. Identify your selected specialty track. Provide a rationale on why you selected the specific professional track. Identify a concept or topic you have a passion about or an area of interest related to your future specialty advanced practice area. Provide an example, using the best evidence available, substantiating the significance of your selected area of interest as it relates to your specific specialty track.
Week 6 discussion
Systems-Structure and Function
Many of you have experience in complex adaptive systems whether you realize it or not. Thinking about your future practice specialty area, identify an issue or concern common to your future practice setting. (Note: This can be the same practice issue identified in Week 5.) In your initial response, please identify your specialty track, as well as the issue or concern. Discuss how this issue or concern impacts the system at the micro, meso, and macro levels. How will you address this issue or concern at the microsystem level? What is the expected impact of your solution on the meso- and macrosystems? Remember you can use an information technology-based solution to address the issue or concern.
Week 7 discussion
Healthful Environments
Reflect on an experience in which you were directly involved or witnessed incivility in the workplace. Provide a brief synopsis of the situation. How did this make you feel? How did you respond? What were the consequences of this situation? Provide an example of how this negatively affected the work environment and outcomes. How could the situation have been prevented? Discuss strategies that would support a healthy work environment.
Week 8 discussion
What Did You Learn
Reflecting on this course, consider and answer the following questions: How do you envision using the AACN essentials and information learned in this course to identify, guide, and evaluate your MSN project? How do you envision using the concepts learned in this course in your future nursing practice?

Assignment: Bioethics Cases in Research
Assignment: Bioethics Cases in Research
Week 6 discussion
DQ1 Although you are not implementing your project at this point and conducting studies with human participants, IRB is an important step in research. State the required components one should look for in a project to determine if IRB submission is needed. Discuss an example of a research study found in one of your literature review articles that needed IRB approval. Specifically, describe why IRB approval was needed in this instance.
DQ2 Visit the Yale Center for Bioethics Cases in Research Ethics website. Choose one of the three cases below to read and respond to in this week’s discussion. Be sure to read the background of the study, the ethical and regulatory issues raised by the IRB, and the comments presented at the end of each case.
Choose from one of these three cases:
Case 1: Payments to subjects who are substance abusers
Case 5: Reasonable right to privacy for patients accessing hospital services
Case 6: An ethnographic study of homeless adolescents
Address the following in your response:
Identify the key ethical issues that are questioned in this case and the category of risk: physical, psychological, social, or economic harm.
Do you feel the level of questioning and concern by the IRB was appropriate? Were you surprised by any of the IRB’s decisions? Explain.
Identify a risk or red flag in this study that you may not have considered on your own prior to reading this study.
Present a new perspective you gained about the IRB, the type of study you read about, the ethics involved, or human subject research processes.
In your replies to peers, respond to at least one peer who chose a different study.

Assignment:Vaginal Birth after C/section
Assignment:Vaginal Birth after C/section
Module 4 discussion
Discussion A/B
Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.
Discussion Group A:
Mary’s 1st baby was delivered via c/section due to the baby being in the breech position. She is requesting a VBAC (vaginal birth after c/section) for this her second baby. By ultrasound this baby is in the vertex position. In reviewing the postoperative report from her first surgery – it is noted that she had a low transverse uterine incision.
What are your thoughts on having a vaginal birth with this second baby?
What education can you provide to her?
What is the risk to her and does this change your thoughts and advise?
Group B Response
Mary is not progressing in labor appropriately, and the decision has been made to move toward a cesarean section. She understands, agrees, and signs the consent for surgery. You will again accept this patient in the recovery – or initial postpartum period.
Recognize that you will complete BUBBLEHE assessment. In addition, the abdominal assessment will also include assessment of the incision. Note the type of dressing used to cover the incision. Is it approximated? Is there any bleeding? Does she have bowel sounds? Is the abdomen distended? Is it soft? Do you assess the fundus and where is it located? It should be firm. Note pain assessment.
Discussion Group B will provide initial post to the following questions, and respond to Group A.
Discussion Group B:
Postpartum:
Susan P. had a SVD (spontaneous vaginal delivery) today approximately 2 hours ago. The labor and delivery nurse is calling to give you report. She is new and not sure what you want to know from her.
What questions do you need to ask to provide comprehensive care to this patient once she is transferred into your care?
Group A Response
Note that you discover that Susan is Rh negative, her baby is Rh positive. What now?
Please discuss Rhogam. The drug, the need, the route, the risk.
When must you give this and under what circumstances will you give this injection?
Please also recall any other reason Rhogam would be given, and when.
Module 5 discussion
Discussions A/B
Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.
DISCUSSION A
Group A will complete the initial post. Group B will respond. You are called to the room and find Michael 2 hours old has been very irritable and spitting up large amounts of formula. He is very jittery. You do not know the maternal history before coming into the room so you advise the mother that you would like to return the baby to the nursery for an assessment and monitoring. In the medical record you focus on prenatal history. You witness the baby having some significant tremors. What would you suspect? Michaels VS are: T (axillary) – 36.0, RR- 70, HR- 166, he is very alert, irritable, and does not console easily. Is moving constantly, and sucking very vigorous on the pacifier you provide for comfort. You place the baby under the warmer and obtain what labs?
It is determined that this baby is going through opioid withdrawal. Neonatal Abstinence Syndrome requires close observation and scoring. Methadone may be used. Neonatal Abstinence Syndrome Shows both the signs of withdrawal, scoring and the nursing care of a baby with Neonatal Abstinence Syndrome.
Group B Response
What is your feeling and knowledge regarding breastfeeding this baby?

Assignment: Cardiovascular and Neurologic Conditions
Assignment: Cardiovascular and Neurologic Conditions
Week 10 discussion
Discussion: Diagnosing and Managing Common Cardiovascular and Neurologic Conditions
Cardiovascular and neurologic conditions are among the leading causes of death and hospitalization of women in the United States (Centers for Disease Control and Prevention, 2008a). As an advanced practice nurse, you must routinely monitor patients at risk of these conditions and recommend the appropriate health screenings and preventive services. When assessing patients for these conditions, it is important to keep in mind that while some female patients might present with typical signs and symptoms, others might present with atypical signs and symptoms that are unique to women. For this Discussion, consider signs and symptoms presented by the women in the following case studies and develop differential diagnoses:
Case Study 1
A 48-year-old overweight African American female is in the clinic for a wellness visit. A routine fasting lipid panel returned with the following results:
Total cholesterol: 305 mmol/L
Low-density lipoprotein (LDL): 180 mg/dl
High-density lipoprotein (HDL): 30 mg/dl
Triglycerides: 165 mg/dl
Case Study 2
You are seeing a 63-year-old African American female for a two-week history of intermittent chest pain. The pain varies in intensity and resolves with rest. She does not believe it has increased over time. She is a nonsmoker with a history of hypertension treated with Lisinopril 10 mg once daily. She had an exercise stress test one year ago that was within normal limits. Her physical exam findings are as follows: HR–90, BP–150/92, R–22, O2Sat 98% RA; lungs: clear to auscultation bilaterally; cardiovascular: apical pulse of 90 RRR, no rubs, murmurs, or gallops. Chest wall mildly tender to palpation that reproduces her complaint of pain. Extremities include no clubbing, cyanosis, or edema. The remainder of the exam is within normal limits.
Case Study 3
A 32-year-old Asian American female is in the clinic for a history of recurrent headaches for the past year, occurring monthly, lasting up to 12–18 hours. The headaches are sometimes associated with photophobia, nausea, and vomiting. She takes either acetaminophen or ibuprofen for relief that is not always successful. She uses Ortho Tricyclin for birth control. Her physical exam is within normal limits.
To prepare:
Review Chapter 8 of the Tharpe et al. text and the McSweeney et al. article in this week’s Learning Resources.
Review and select one of the three provided case studies. Analyze the patient information.
Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
Reflect on the appropriate clinical guidelines. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
Consider strategies for educating patients on the treatment and management of the disorder you identified as your primary diagnosis.
715 × 402

Assignment: Treating Clients With Dementia
Assignment: Treating Clients With Dementia
eek 10 assignment
Assignment: Assessing and Treating Clients With Dementia
The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.
Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.asp
Learning Objectives
Students will:
Assess client factors and history to develop personalized therapy plans for clients with dementia
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for dementia
Evaluate efficacy of treatment plans
Analyze ethical and legal implications related to prescribing therapy for clients with dementia
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapter, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 13, “Dementia and Its Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
donepezil
galantamine
memantine
rivastigmine
Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html
Note: Retrieved from from the Walden Library databases.
Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis. Neuropsychopharmacology, 35, 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf
Required Media
Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.
The Assignment
Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

Healthcare Reflective Essay Guidelines
Healthcare Reflective Essay Guidelines
Week 2 assignment
Reflective Essay Guidelines
The Reflective Essay Guidelines with Scoring Rubric is due by Sunday, 11:59 p.m. (MT) at the end of Week 2. The guidelines are below and the guidelines and grading rubric for this assignment are also located in Course Resources.
Purpose
Nursing knowledge is classified in a variety of ways, one of which is Carper’s Patterns of Knowing (Carper, 1978). Carper’s framework offers a lens through which the nurse can reflect upon insights acquired through empirical, ethical, personal, and aesthetic knowledge (Carper, 1978). Through intentional reflection using Carper’s Patterns of Knowing, nurses can process experiential learning and knowledge acquired through practice. The purpose of this assignment is to reflect upon a specific practice situation and better understand the professional knowledge and insights obtained through that experience.
Course Outcomes
Through this assessment, the student will meet the following Course Outcomes:
Demonstrate logical and creative thinking in the analysis and application of theory to nursing practice. (CO #1)
Examine broad theoretical concepts as foundational to advanced nursing practice roles. (CO #3)
Total Points Possible
This assignment is worth 100 points.
Due Date
Submit your file by 11:59 p.m. MT Sunday at the end of Week 2.
Requirements
Criteria for Content
Think of a surprising or challenging practice situation in which you felt underprepared, unprepared, or uncomfortable.
Select an important nursing issue/topic that was inherent to the identified situation.
As a method of refection, use Carper’s Patterns of Knowing to analyze the situation. In a two- to three-page paper address the following:
Briefly explain the situation
Identify the nursing issue inherent in the identified situation
What do you think was the underlying reason for the situation? (Esthetics)
What were your thoughts and feeling in the situation? (Personal)
What was one personal belief that impacted your actions? (Ethics)
What evidence in nursing literature supports the nursing importance of the identified issue? (Empirical)
What new insights did you gain through this reflective practice opportunity?
Preparing the paper
Submission Requirements
Application: Use Microsoft Word 2013™ to create the written component of this assessment.
Length:
The paper (excluding the title page and reference page) should be at least two but no more than three pages.
A minimum of two (2) scholarly literature sources must be used.
Submission: Submit your file to the Canvas course site by the due date/time indicated.
Best Practices in Preparing the Reflective Essay
The following are best practices in preparing this reflective essay.
Review directions thoroughly.
Follow assignment requirements.
Make sure all elements on the grading rubric are included.
Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scholarly writing.
Because the paper is a reflective essay, first person is acceptable for this assignment.
Title page, running head, body of paper, and reference page must follow APA guidelines as found in the 6th edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
Ideas and information that come from scholarly literature must be cited and referenced correctly.
A minimum of two (2) scholarly literature sources must be used.
Abide by CCN academic integrity policy.

Evidence-Based Practice Proposal
Evidence-Based Practice Proposal
Evidence-Based Practice Proposal – Section D: Solution Description
Write a paper of 500-750 words (not including the title page and reference page) paper for your proposed evidence-based practice project solution. Address the following criteria:
Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing.
Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.
Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT.
Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed.
Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, and/or professional expertise.
Prepare this assignment according to the APA 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.
Upon receiving feedback from the instructor, refine “Section D: Solution Description” for your final submission. This will be a continuous process throughout the course for each section.

Case Study: Patient Education
Case Study: Patient Education
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.
Question 2
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.

Case Scenario: Tuberculosis
Case Scenario: Tuberculosis
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.
Question 2
Module 1 discussion
Preventative Care / Care of Women and Children
Respond to each discussion prompt as your initial post. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.
Group A:
Healthy People 2010 – is a guide to promote preventative care. Review primary, secondary and tertiary prevention and relate this to women and children at risk in your community. Identify those risk factors that a prevention program could impact the health of the group you identify.
This video is the Healthy People 2020 initiative
Group B:
Please research medical technological advances that may be unique to the care of women and children. Discuss how this technology will improve care to women and children. (ideas may be: genetic screening, public health initiatives, mammography, cervical screening, Fetal monitoring, Electronic medical records, telemedicine).
Which technological advances have been utilized in your local hospital? How has it impacted the care of women and children?
Module 2 discussion
Emergency Contraception / Emergency Department
Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.
Group A will complete the following discussion and then respond to Group B discussion.
Emergency Contraception:
A16 year old reports to the local Family Planning clinic with concerns regarding pregnancy. She relates she had unprotected intercourse 2 nights ago and believes she may be ‘fertile’. She wants to learn more about the ‘morning after pill’
What additional information should you obtain from her?
What do you know about emergency contraception and the side effects?
What educational points should you provide to her?
Group B will complete the following discussion and respond to Group A’s discussion post.
Vaginal Bleeding in pregnancy:
A pregnant patient arrives in the Emergency Department with complaints of vaginal bleeding. You will choose the gestational age of your patient, and based on that gestational age answer the following questions:
Knowing the gestational age, provide information on LMP, and EDD
What are the possible reasons she is bleeding at this gestational age?
What are your nursing interventions for this issue, and please include education to your patient.
Module 3 discussion
Labor Management
Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.
Part 1: An 18 year old Primigravida presents to Labor And Delivery with what appears to be active labor. Upon questioning, you discover she has received no prenatal care. In obtaining some history while placing her on the fetal monitor you learn she is a smoker, approximately 1 pack per day, occasional marijuana for stress, and denies any support system. The Father of the Baby (FOB) has no knowledge of the pregnancy. No prenatal vitamins – they were too hard to swallow. She has no idea when her LMP was and she relates always being very irregular. * remember LMP is to ask the first day of the Last Menstrual cycle, not when the bleeding stopped*
What other questions are essential for her safe care?
What lab values do you need to obtain?
What exam findings should you obtain at this time?
What education will you provide for her?
She asks you how long this will take to have the baby – what is your best response?
Group B
Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.
How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?
Preterm Labor Management
Preterm labor