CO6 Develop a personal awareness of complex organizational systems, and integrate values and beliefs with organizational mission. (PO 7)

Complete the Week 8 AACN Essentials Self-Assessment

https://lms.courselearn.net/lms/CourseExport/files/49c974d3-9946-4b3e-bbfc-957a48792360/NR447_W8_AACN_Essentials_Self-Assessment.docx

Compare your scores from Week 2 (score 39)to Week 8.

Describe how far have you come and how much further do you wish to go in improving your competencies during the next two years of practice.

Next, review the Course Outcomes as listed in the Syllabus. Select one of the course outcomes and share with your classmates how you feel you have achieved the outcome and how you will utilize the essentials and course outcomes in your practice setting.

  

1-Great response.  You brought up many points that I overlooked.  I love the info on assessing the community.  Of course you need to assess the community on their spiritual needs and reaction to the disaster.  There could be people at risk of harming themselve or others.  It is important to gauge the community members and provide them with the proper support they need.  A community health nurse has a very important job when dealing with disasters.  

  

2-What we call holistic care in nursing involves the mind, body and spirit. If we are required to care for our patients this way for them to be healed as a whole person, then it should be part of their health care. I think there should be reimbursement for it. Spiritual care is important in the care of patients.  

  

3-During disasters, people suffer psychological and emotion stress.  There are many types of disasters that cause emotional stress, like school shootings, mass shootings, bombings, and weather-related disasters. They witness some traumatizing events that may haunt them.  They may question why God allowed this to happen.  They may wonder about their beliefs of God. They may feel the need to push others away, so they do not get hurt.  They may feel guilty or angry.  They may question life and death and its purpose. The community will ask the same questions as well.  Community leaders may feel overwhelmed while trying to care for their community members like when Las Vegas had the mass shooting during a country concert.  The community of Las Vegas and country music came together to support the victims and the community.  Health care worker, first responders, and the community, caring for the victims struggle to save lives and lose precious lives.  They worked to save lives and to provide emotional support to the victims. After the day was over, the workers themselves were the ones that needed to be cared for emotionally and mentally.  They are mentally drained and need counseling themselves.

A community nurse health nurse can assist with all aspects of nursing, triaging the injured, as well as population-based practices, rapid assessment of the community’s needs, handing out of preventative and treatments, education, providing shelter or resources for shelter, and staples to survive or resources to facilitate those staples (Association of Public Health Nurses, 2013).  They also can provide the spiritual support that people need.  They should offer spiritual support by offering spiritual care by being present and hospitality, nonjudgmental listening, providing no harm, and confidentiality. Encourage their faith to get them through the disaster, attempt to normalize and understand their situation.  They should also be ready to provide spiritual resources and assistances (National Disaster Interfaith Network, n.d.).  The community can assist her colleagues by listening to them and providing them with resources for spiritual support. 

APA format 1 page long 3 references and please include one from discussion post

MSN degree Need ASAP for 9/7/19.

  

Audience

 First-year nursing students come in an associate degree nursing program have typical prerequisite coursework, yet often come with a high degree of variable life experiences. Nursing students, in general, are academic achievers who could not be admitted to their program without a high grade point average. Prerequisite coursework, such as anatomy and physiology, resides at the knowledge and comprehension level of Bloom’s taxonomy, which requires students to explain, memorize, and describe concepts (Bristol & Kerwekh, 2011).  Early nursing coursework begins to include application and analysis where students must criticize, compare, and develop ideas. For many, this is a big leap. Bradshaw and Hultquist (2017) describe that students’ progress through learning via set steps. The first step is dualistic thinking where concepts are black and white. This progresses to multiplicity, where more diverse ideas are tolerated. Nursing students also experience a difficult transition to understanding the conceptual grey areas.

Learning Need

            Early in the nursing program, students are expected to identify scholarly versus non-scholarly sources of information. Students are expected to include scholarly sources in their self-directed learning and include these in their assignments. Being able to evaluate evidence is critical for patient safety as they advance in their training and career (Horntvedt, Nordsteien, Fermann, & Severinsson, 2018).  The following are two learning objectives for this lesson:

• Summarize the difference between academic and non-academic sources of nursing knowledge
• Provide two examples of academic sources of knowledge

Horntvedt et al. (2018) found that interactive teaching and integration into clinical practice were effective strategies for teaching students to evaluate evidence.  The learning activity will provide necessary information about scholarly sources of information in an online format. This lesson will use a video presentation to highlight critical concepts related to assessing academic sources of information. During the lesson, students will be shown five different sources of information and be asked to rank the sources in order of most reliable to least reliable.

Evaluation

            Shank (2005) emphasizes the need to match the skill level of the learner with the learning objectives and activities. For first-year nursing students, a basic understanding of scholarly versus non-scholarly work is appropriate. An analysis of formal research study validity is beyond the scope of what is needed at their level. The verb summarize corresponds with the knowledge level of learning in Bloom’s taxonomy. The second objective asks the student to provide two examples, which demonstrates comprehension-level understanding in Bloom’s. Both objectives, if successfully met, will allow the student to complete the required work, accessing scholarly work, successfully.

References

Bradshaw, M. J., & Hultquist, B. L.  (2017). Innovative teaching strategies in nursing and

            related health professions (7th ed.). Burlington, MA: Jones and Bartlett.

Bristol, T. J., & Zerwekh, J. (2011). Essentials of e-learning for nurse educators. Philadelphia,

            PA: F. A. Davis Company.

Horntvedt, M.-E. T., Nordsteien, A., Fermann, T., & Severinsson, E. (2018). Strategies for

teaching evidence-based practice in nursing education: a thematic literature review. BMC MEDICAL EDUCATION, 18. https://doi-org.ezp.waldenulibrary.org/10.1186/s12909-018-1278-z

Shank, P. (2005). Writing learning objectives that help you teach and students learn (Part 1).

 Online Classroom, 4–7. Retrieved from the Walden Library databases.

Describe a clinical situation in which a registered nurse may encounter moral distress.  Answer the AACN’s Four A’s found on page 84 in your Butts and Rich text to further explain the situation, and the possible mitigation strategies.

Nurses use the Four A’s plan as a guide to identify and analyze moral distress:

•  Ask appropriate questions to become aware that moral distress is present.

•  Affirm your distress and commitment to take care of yourself and address moral distress.

•  Assess sources of your moral distress to prepare for an action plan.

•  Act to implement strategies for changes to preserve your integrity and authenticity.

Preventing moral distress requires nurses to recognize the at-risk dynamics and issues. An environment of good communication and respect for others is essential for decreasing the likelihood of experiencing moral distress.

  

Question

Question 1 1 / 1 point

Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:

Question options:

Increases peripheral vasoconstriction

Decreases detrusor muscle contractility

Lowers supine blood pressure more than standing pressure

Relaxes smooth muscle in the bladder neck

Question 2 1 / 1 point

Which of the following adverse effects are less likely in a beta1-selective blocker?

Question options:

Dysrhythmias

Impaired insulin release

Reflex orthostatic changes

Decreased triglycerides and cholesterol

Question 3 1 / 1 point

Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the:

Question options:

Symptoms are severe

Patient has not responded to other therapies

Patient has concurrent hypertension

Left ventricular dysfunction is diagnosed

Question 4 1 / 1 point

You are treating a patient with a diagnosis of Alzheimer’s disease. The patient’s wife mentions difficulty with transportation to the clinic. Which medication is the best choice?

Question options:

Donepezil

Tacrine

Doxazosin

Verapamil

Question 5 1 / 1 point

Antonia is a 3-year-old child who has a history of status epilepticus. Along with her routine antiseizure medication, she should also have a home prescription for_________ to be used for an episode of status epilepticus.

Question options:

IV phenobarbital

Rectal diazepam (Diastat)

IV phenytoin (Dilantin)

Oral carbamazepine (Tegretol)

Question 6 1 / 1 point

Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:

Question options:

Dwayne hasn’t been taking his carbamazepine because it causes insomnia.

Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.

Dwayne was not originally prescribed the correct amount of carbamazepine.

Carbamazepine is probably not the right antiseizure medication for Dwayne.

Question 7 1 / 1 point

Kasey fractured his ankle in two places and is asking for medication for his pain. The appropriate first-line medication would be:

Question options:

Ibuprofen (Advil)

Acetaminophen with hydrocodone (Vicodin)

Oxycodone (Oxycontin)

Oral morphine (Roxanol)

Question 8 1 / 1 point

Jack, age 8, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:

Question options:

Slurred speech and insomnia

Bradycardia and confusion

Dizziness and orthostatic hypotension

Insomnia and decreased appetite

Question 9 1 / 1 point

An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:

Question options:

Alprazolam (Xanax)

Diazepam (Valium)

Buspirone (Buspar)

Amitriptyline (Elavil)

Question 10 1 / 1 point

David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David’s education regarding his medication would include:

Question options:

Paroxetine may cause intermittent diarrhea.

He may experience sexual dysfunction beginning a month after he starts therapy.

He may have constipation and he should increase fluids and fiber.

Paroxetine has a long half-life so he may occasionally skip a dose.

Question 11 1 / 1 point

An appropriate drug for the treatment of depression with anxiety would be:

Question options:

Alprazolam (Xanax)

Escitalopram (Lexapro)

Buspirone (Buspar)

Amitriptyline (Elavil)

Question 12 1 / 1 point

The longer-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason?

Question options:

They have become tolerant of the medication, which is characterized by the need for higher and higher doses.

They are a drug seeker.

They are suicidal.

They only need additional counseling on lifestyle modification.

Question 13 1 / 1 point

A first-line drug for abortive therapy in simple migraine is:

Question options:

Sumatriptan (Imitrex)

Naproxen (Aleve)

Butorphanol nasal spray (Stadol NS)

Butalbital and acetaminophen (Fioricet)

Question 14 1 / 1 point

Xi, a 54-year-old female, has a history of migraines that do not respond well to OTC migraine medication. She is asking to try Maxalt (rizatriptan) because it works well for her friend. Appropriate decision making would be:

Question options:

Prescribe the Maxalt, but only give her four tablets with no refills to monitor the use.

Prescribe Maxalt and arrange to have her observed in the clinic or urgent care with the first dose.

Explain that rizatriptan is not used for postmenopausal migraines and recommend Fiorinal (aspirin and butalbital).

Prescribe sumatriptan (Imitrex) with the explanation that it is the most effective triptan.

Question 15 1 / 1 point

Kelly is a 14-year-old patient who presents to the clinic with a classic migraine. She says she is having a headache two to three times a month. The initial plan would be:

Question options:

Prescribe NSAIDs as abortive therapy and have her keep a headache diary to identify her triggers.

Prescribe zolmitriptan (Zomig) as abortive therapy and recommend relaxation therapy to reduce her stress.

Prescribe acetaminophen with codeine (Tylenol #3) for her to take at the first onset of her migraine.

Prescribe sumatriptan (Imitrex) nasal spray and arrange for her to receive the first dose in the clinic.

Question 16 1 / 1 point

James has been diagnosed with cluster headaches. Appropriate acute therapy would be:

Question options:

Butalbital and aspirin (Fiorinal)

Meperidine IM (Demerol)

Oxygen 100% for 15 to 30 minutes

Indomethacin (Indocin)

Question 17 1 / 1 point

If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on the severity of pain. Drugs are given in which order of use?

Question options:

NSAIDs, opiates, corticosteroids

Low-dose opiates, salicylates, increased dose of opiates

Opiates, non-opiates, increased dose of non-opiate

Non-opiate, increased dose of non-opiate, opiate

Question 18 1 / 1 point

Chemical dependency assessment is integral to the initial assessment of chronic pain. Which of the following raises a “red flag” about potential chemical dependency?

Question options:

Use of more than one drug to treat the pain

Multiple times when prescriptions are lost with requests to refill

Preferences for treatments that include alternative medicines

Presence of a family member who has abused drugs

Question 19 1 / 1 point

The Pain Management Contract is appropriate for:

Question options:

Patients with cancer who are taking morphine

Patients with chronic pain who will require long-term use of opiates

Patients who have a complex drug regimen

Patients who see multiple providers for pain control

Question 20 1 / 1 point

Which of the following statements is true about age and pain?

Question options:

Use of drugs that depend heavily on the renal system for excretion may require dosage adjustments in very young children.

Among the NSAIDs, indomethacin is the preferred drug because of lower adverse effects profiles than other NSAIDs.

Older adults who have dementia probably do not experience much pain due to loss of pain receptors in the brain.

Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs.