Nursing

Case Study: Neurological System
Case Study: Neurological System
This week’s graded discussion topic relates to the following Course Outcomes (COs).
CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
CO2 Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO 1)
CO3 Utilize effective communication when performing a health assessment. (PO 3)
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.
Pathophysiology of concussive injuries and treatment
Neurological assessment tools used in your current practice setting (if not presently working, please describe one used during prior employment or schooling)
Current best practices associated with post-traumatic stress disorder (PTSD)
Nursing interventions you would include in this patient’s plan of care
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.

Discuss:Musculoskeletal System and Pain
Discuss:Musculoskeletal System and Pain
This week’s graded discussion topic relates to the following Course Outcomes (COs)
CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities (PO 1)
CO2 Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning (PO 1)
CO3 Utilize effective communication when performing a health assessment (PO 3)
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
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
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?
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?

Assignment:Conducting Physical Exam
Assignment:Conducting Physical Exam
MIDTERM EXAM
Question 1
A patient reports “something flew in my eye” about an hour ago while he was splitting logs. If there were a foreign body in his eye, the nurse practitioner would expect to find all except:
Question 2
Your well-nourished 75-year-old patient has come into the office for a physical exam and states that she recently had two nosebleeds. She does not take any anticoagulants, and you have ruled out any coagulopathies. The most likely cause of these nosebleeds is:
Question 3
Mark has just been given a diagnosis of congestive heart failure. Which of his medications should be discontinued?
Question 4
A 55 year old patient has a work-up for hypertension and is noted to have elevated BUN and creatinine. Which of the following should the nurse practitioner suspect?
Question 5
Which of the following is the most important diagnosis to rule out in the adult patient with acute bronchitis?
Question 6
Risk factors for acute arterial insufficiency include which of the following?
Question 7
What is the Gold standard for the diagnosis of asthma?
Question 8
Which of the following dermatologic vehicles are the most effective in absorbing moisture and decreasing friction?
Question 9
Amaurosis fugax is described as a:
Question 10
Jennifer, age 49, who has a history of hyperlipidemia, has symptoms that lead you to suspect unstable angina. Your next action would be to:
Question 11
Which of the following patient characteristics are associated with chronic bronchitis?
Question 12
In the initial evaluation of a patient with new onset hypertension, the nurse practitioner should:
Question 13
John, age 59, presents with recurrent, sharply circumscribed red papules and plaques with a powdery white scale on the extensor aspect of his elbows and knees. What do you suspect?
Question 14
A 2 year old presents with a white pupillary reflex. What is the most likely cause of this finding?
Question 15
Expected spirometry readings when the patient has chronic emphysema include:
Question 16
Larry, age 66, is a smoker with hyperlipidemia and hypertension. He is 6 months post-MI. To prevent reinfarction, the most important behavior change that he can make is to:
Question 17
A 58-year-old man is diagnosed with Barrett’s esophagus after an endoscopy. He has no known allergies. Which of the following medications is MOST appropriate to treat this patient’s disorder?
Question 18
A 57-year-old male presents to urgent care complaining of substernal chest discomfort for the past hour. The EKG reveals ST elevations in Leads II, III, and AVF. The nurse practitioner is aware that these changes are consistent with which myocardial infarction territory?

Assignment: Concept Map-Hypertension
Assignment: Concept Map-Hypertension
odule 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 medicationnot 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.
Clinical Manifestations
Subjective:
Objective:
Possible Nursing Diagnosis
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How to Conduct Physical Exam
How to Conduct Physical Exam
Week 6 discussion
This week’s content discussed common psychiatric disorders in the Adult and Older Adult client. Often times a secondary diagnosis is masked due to their psychiatric disorder. Review the following case study and answer the following questions.
Mr. White is a 72-year-old man, with a history of hypertension, COPD and moderate dementia, who presents with 4 days of increased confusion, nighttime restlessness, visual hallucinations, and urinary incontinence. His physical exam is unremarkable except for tachypnea, a mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score from a baseline of 18 to 12 today.
Mr. White’s presentation is most consistent with an acute delirium (acute change in cognition, perceptual derangement, waxing and waning consciousness, and inattention).
What is the most likely diagnosis to frequently cause acute delirium in patients with dementia?
What additional testing should you consider if any?
What are treatment options to consider with this patient?
ORDER NOW FOR AN ORIGINAL PAPERDiscuss:Case Study: Discuss Fibromyalgia
Week 6 discussion
This week’s content discussed common psychiatric disorders in the Adult and Older Adult client. Often times a secondary diagnosis is masked due to their psychiatric disorder. Review the following case study and answer the following questions.
Mr. White is a 72-year-old man, with a history of hypertension, COPD and moderate dementia, who presents with 4 days of increased confusion, nighttime restlessness, visual hallucinations, and urinary incontinence. His physical exam is unremarkable except for tachypnea, a mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score from a baseline of 18 to 12 today.
Mr. White’s presentation is most consistent with an acute delirium (acute change in cognition, perceptual derangement, waxing and waning consciousness, and inattention).
What is the most likely diagnosis to frequently cause acute delirium in patients with dementia?
What additional testing should you consider if any?
What are treatment options to consider with this patient?

Assignment: Acute Complications of Diabetes
Assignment: Acute Complications of Diabetes
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?
Assignment: Acute Complications of Diabetes

Assignment: Antibiotic Therapy
Assignment: Antibiotic Therapy
Question 26
Which of the following statements is correct about the varicella vaccine?
Question options:
1) This vaccine contains killed varicella-zoster virus (VZV).
2) A short febrile illness is common during the first days after vaccination.
3) Children should have a varicella titer drawn before receiving the vaccine.
4) Rarely, mild cases of chickenpox have been reported in immunized patients.
Question 27
A healthy 6-year-old girl presents for care. Her parents request that she receive vaccination for influenza and report that she has not received this vaccine in the past. How many doses of influenza vaccine should she receive this flu season?
Question options:
1) 1.
2) 2.
3) 3.
4) 4.
Question 28
At which of the following ages in a young child’s life is parental anticipatory guidance about toilet-training readiness most helpful?
Question options:
1) 12 months.
2) 15 months.
3) 18 months.
4) 24 months.
Question 29
The murmur of atrial septal defect is usually:
Question options:
1) found in children with symptoms of cardiac disease.
2) first found on a 2–6-month well-baby examination.
3) found with mitral valve prolapse.
4) presystolic in timing.
Question 30
You are examining an 18-month-old boy who is not speaking any discernible words. Mom tells you he has not said “mama or dada” yet or babbled or smiled responsively. You:
Question options:
1) encourage the mother to enroll her son in daycare to increase his socialization.
2) conduct further evaluation of milestone attainment.
3) reassure the parent that delayed speech is common in boys.
4) order audiogram and tympanometry.
Question 31
Treatment options for streptococcal pharyngitis for a patient with penicillin allergy include all of the following except:
Question options:
1) azithromycin.
2) trimethoprim-sulfamethoxazole.
3) clarithromycin.
4) clindamycin.
Question 32
Which of the following is one of the more common sources of hepatitis A infection in the United States?
Question options:
1) Receiving blood products.
2) Ingestion of raw shellfish.
3) Drinking municipally sourced tap water drinking water.
4) Exposure to fecally contaminated food.
Question 33
Juice intake is acceptable in children 6 months and older per which of the following recommendations? Select all that apply.
Question options:
1) The juice is mixed in small amounts to flavor water.
2) Only 100% juice is used.
3) Juice replaces no more than one serving of milk.
4) The juice is consumed in the morning with breakfast.
5) No more than 6 oz. (177 mL) per day is recommended for children 6 months to 5 years.
Question 34
Treatment of viral conjunctivitis can include:
Question options:
1) moxifloxacin ophthalmic drops.
2) polymyxin B ophthalmic drops.
3) oral acyclovir.
4) no antibiotic therapy needed.
Question 35 1 / 2 points
Which of the following benchmarks indicate normal development by a healthy child born at term who is now 12 months of age? Select all that apply.
Question options:
1)
Talking in two-word sentences.
2)
Pointing to a desired object.
3)
Reaching for a desired object.
4)
Walking backward.

Diversity in the Healthcare Workforce
Diversity in the Healthcare Workforce
The Course Outcome covered this week is CO2
CO2: Communicate effectively with culturally diverse individuals, families, and organizations (PO3)
As nurses, we work with providers and healthcare team members whose native language is not English In fact, some of you may have interviewed a non-native English speaker for your Course Project This diversity may lead to challenges with communication and the nurse being “caught in the middle”
Reflect on your newfound knowledge of transcultural nursing
Share an example of miscommunication that occurred as a result of this diversity and whether an adverse outcome resulted
Describe how the miscommunication could have been and will be prevented in the future
Increasing the racial and ethnic diversity of the health care workforce is essential for the adequate provision of culturally competent care to our nation’s burgeoning minority communities. A diverse health care workforce will help to expand health care access for the underserved, foster research in neglected areas of societal need, and enrich the pool of managers and policymakers to meet the needs of a diverse populace. The long-term solution to achieving adequate diversity in the health professions depends upon fundamental reforms of our country’s precollege education system. Until these reforms occur, affirmative action tools in health professions schools are critical to achieving a diverse health care workforce.
Increasing the racial and ethnic diversity of the health care workforce is essential for the adequate provision of culturally competent care to our nation’s burgeoning minority communities. A diverse health care workforce will help to expand health care access for the underserved, foster research in neglected areas of societal need, and enrich the pool of managers and policymakers to meet the needs of a diverse populace. The long-term solution to achieving adequate diversity in the health professions depends upon fundamental reforms of our country’s precollege education system. Until these reforms occur, affirmative action tools in health professions schools are critical to achieving a diverse health care workforce.
720 × 300

Nurse of the Future Nursing Core Competencies
Nurse of the Future Nursing Core Competencies
This week’s graded discussion topic relates to the following Course Outcomes (COs).
CO2 Demonstrate leadership strategies that promote safety and improve quality in nursing practice and increase collaboration with other disciplines when planning patient-centered care within systems-based practice. (PO 2)
CO4 Integrate critical thinking and judgment in professional decision-making in collaboration with faculty and peers. (PO 4)
CO9 Demonstrate accountability for personal and professional development by assessing information and technology competence, implementing plans for upgrading technology skills, and using effective strategies for online student success using success resources provided to Chamberlain students. (PO 5)
Now that you have examined the Nurse of the Future Nursing Core Competencies, why do you think these competencies were selected? Which 2 of the 10 competencies will be most important to your future nursing practice and why?
Week 2 discussion
Interprofessional Collaboration Strategies
This week’s graded discussion topic relates to the following Course Outcomes (COs).
CO2 Demonstrate leadership strategies that promote safety and improve quality in nursing practice and increase collaboration with other disciplines when planning patient-centered care within systems-based practice. (PO 2)
CO4 Integrate critical thinking and judgment in professional decision-making in collaboration with faculty and peers. (PO 4)
CO9 Demonstrate accountability for personal and professional development by assessing information and technology competence, implementing plans for upgrading technology skills, and using effective strategies for online student success using success resources provided to Chamberlain students. (PO 5)
In today’s changing healthcare environment, it is more important than ever for professional nurses to be skilled in collaborating with professionals from other healthcare disciplines. What communication strategies can professional nurses use to specifically promote collaboration with other healthcare disciplines and professionals?
Week 3 discussion
Integration of Evidence-Based Practice Into Professional Nursing Practice
This week’s graded discussion topic relates to the following Course Outcomes (COs).
CO1 Propose individualized comprehensive care by integrating theories and principles of nursing and related disciplines when planning comprehensive patient-centered care. (PO 1)
CO2 Demonstrate leadership strategies that promote safety and improve quality in nursing practice and increase collaboration with other disciplines when planning patient-centered care within systems-based practice. (PO 2)
CO8 Discuss the role of evidence-based practice in the provision of professional nursing care. (PO 8)
As the professional nurse, you realize that your nursing care area often sees patients with the same particularly challenging nursing care issue (not medical care issue). Include all of the following in your answer to this discussion.
Identify the nursing care issue or problem and justify why it is a nursing care issue in need of implementation of evidence. Remember, this should not be a medical issue.
Explain how you would search CINAHL for evidence on this topic (including search terms you would use) and how you would critically appraise the evidence found in your search. Note: You do not need to perform the search or provide an article for this discussion, but you may do so if you like.
960 × 746

Assignment:Conflict in Older population
Assignment:Conflict in Older population
Question 1
Watch at least 60 minutes of TV, focusing on the depiction of older adults. Analyze and discuss TV programming in the context of at least two of the following:
Portrayal of elderly characters
Intergenerational themes
Conflict in relation to the older population
Aging stereotypes or myths
Cultural diversity in relation to quality of care
Question 2
Discuss your own philosophy of aging. When do you think a person becomes elderly? What do you think of older people? Are they active, senile, debilitated, etc.? Give a description of an elderly person that you know.
Week 2 discussion
Discussion Question 1
What do you think are the two most prevalent age-related changes that affect the lifestyle of the elderly? How would you help an elderly patient adjust to the two changes you identified?
Discussion Question 2
Identify at least two modes of communication you have used for the elderly in your clinical practice. State what modes of communication were effective and which modes were challenging. Explain why.
Week 3 discussion
Develop a wellness program with a holistic approach for the older adult you identified, using resources available in your community. Discuss how this approach will prove an optimum level of well-being.
Week 4 discussion
Identify two strategies you can implement to provide comfort to maintain function with an ethnically diverse older adult with a chronic disease? This can be nutrition, ADLs, exercise, etc.
Week 5 discussion
There are many types of elder abuse. Choose two types and discuss challenges you perceive in abolishing them. Justify why you consider them as the most crucial. Discuss how you can advocate and protect the elderly from abuse.
Discuss your own philosophy of aging. When do you think a person becomes elderly? What do you think of older people? Are they active, senile, debilitated, etc.? Give a description of an elderly person that you know.