Field of study:  Nursing

(minimum of 250 words with peer review)

 

You attend a local health fair organized by several health care research companies. You notice that a company is distributing a trial drug to other attendees at one of the booths. When you approach one of the researchers, you are offered a waiver to sign for participation in the trial.

What ethical or legal parameters should the researchers have considered prior to distributing the trial drug at the health fair? If you were on the translational research team, what steps would you have taken to maintain ethical and legal guidelines?

Case Study, Chapter 8, Unlicensed Assistive Personnel and the Registered Nurse The increased use of unlicensed assistive personnel presents both opportunities and challenges for the American health care system. The nurse manager has to deal with the challenge that unlicensed assistive personnel only be used to provide personal care needs or nursing tasks that do not require the skill and judgment of the RN.1. The nurse manager reviews the national effort to define the scope of practice for unlicensed assistive personnel. In 2007, the American Nurses Association made recommendations for a national and/or state policy for nursing assistive personnel. What are the six actions that should be taken to create a national and/or state policy agenda about the educational preparation of unlicensed assistive personnel and the competencies they should have for safe practice?2. The need in health care today is for today’s nurses to have highly developed delegation skills in working effectively and efficiently with unlicensed assistive personnel. This is critical to ensure the clients’ needs are met and their safety is not jeopardized. What are the key general principles that the nurse manager needs to review with professional registered nurses in delegating to unlicensed assistive personnel?

 You are caring for a 13-year old adolescent girl admitted and diagnosed two days ago to your pediatric unit with Type 1 diabetes. Her primary care giver is her mother who is present at the bedside.

Case Study Analysis Assignment Outline:

Introduction
Brief overview of the pathophysiology of the disease. Include:
What lab abnormalities would you look for?
What diagnostics would you expect to see?
Give rationale.
Implications for Self-Care
How does this disease process impact the patient’s and/or their care provider’s ability to care for themselves?
Consider Maslow’s hierarchy of needs
Application of Orem’s Theory of Self-Care.
Patient Education Strategy
Consider educational strategies and a plan of care for your patient based on the implications for self-care section. Support with rationale.
Interdisciplinary Collaboration
What interdisciplinary team members need to be included. Include rationale.
Consider nutrition, discharge, transition, and financial implications
Conclusion 

Lyme Disease 

A 38-year-old male had a 3-week history of fatigue and lethargy with intermittent complaints of headache, fever, chills, myalgia, and arthralgia. According to the history, the patient’s symptoms began shortly after a camping vacation. He recalled a bug bite and rash on his thigh immediately after the trip. The following studies were ordered: 

Studies Results Lyme disease test: Elevated IgM antibody titers against Borrelia burgdorferi (normal: low) 

Erythrocyte sedimentation rate (ESR), 30 mm/hour (normal: ≤15 mm/hour) Aspartate aminotransferase (AST), 32 units/L (normal: 8-20 units/L) 

Hemoglobin (Hgb), 12 g/dL (normal: 14-18 g/dL) 

Hematocrit (Hct), 36% (normal: 42%-52%) 

Rheumatoid factor (RF), Negative (normal: negative) 

Antinuclear antibodies (ANA), Negative (normal: negative) 

Diagnostic Analysis 

Based on the patient’s history of camping in the woods and an insect bite and rash on the thigh, Lyme disease was suspected. Early in the course of this disease, testing for specific immunoglobulin (Ig) M antibodies against B. burgdorferi is the most helpful in diagnosing Lyme disease. An elevated ESR, increased AST levels, and mild anemia are frequently seen early in this disease. RF and ANA abnormalities are usually absent. 

Critical Thinking Questions 

1. What is the cardinal sign of Lyme disease? (always on the boards) 

2. At what stages of Lyme disease are the IgG and IgM antibodies elevated? 

3. Why was the ESR elevated? 

4. What is the Therapeutic goal for Lyme Disease and what is the recommended treatment.

Peripheral Vascular Disease 

A 52-year-old man complained of pain and cramping in his right calf caused by walking two blocks. The pain was relieved with cessation of activity. The pain had been increasing in frequency and intensity. Physical examination findings were essentially normal except for decreased hair on the right leg. The patient’s popliteal, dorsalis pedis, and posterior tibial pulses were markedly decreased compared with those of his left leg. 

Studies Results Routine laboratory work Within normal limits (WNL) 

Doppler ultrasound systolic pressures Femoral: 130 mm Hg; popliteal: 90 mm Hg; posterior tibial: 88 mm Hg; dorsalis pedis: 88 mm Hg (normal: same as brachial systolic blood pressure) 

Arterial plethysmography Decreased amplitude of distal femoral, popliteal, dorsalis pedis, and posterior tibial pulse waves 

Femoral arteriography of right leg Obstruction of the femoral artery at the midthigh level 

Arterial duplex scan Apparent arterial obstruction in the superficial femoral artery 

Diagnostic Analysis 

With the clinical picture of classic intermittent claudication, the noninvasive Doppler and plethysmographic arterial vascular study merely documented the presence and location of the arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography to document the location of the vascular occlusion. The patient underwent a bypass from the proximal femoral artery to the popliteal artery. After surgery he was asymptomatic. 

Critical Thinking Questions 

1. What was the cause of this patient’s pain and cramping? 

2. Why was there decreased hair on the patient’s right leg? 

3. What would be the strategic physical assessments after surgery to determine the adequacy of the patient’s circulation? 

4. What would be the treatment of intermittent Claudication for non-occlusion? 

For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/

To Prepare

• Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
• Select one type of diabetes to focus on for this Discussion.
• Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
• Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.

Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.