Nursing Philosophy/QEP Writing Assignment The personal philosophy must include the following domains: Nursing, Environment, Health and Person. You should include your personal definition of each domain and how these fit into your philosophy of nursing. In preparing your philosophy the faculty require that you review the philosophies of at least one hospital. A limit of 1 to 2 pages is acceptable in APA format. The guidance of the assignment rubric should be utilized to achieve maximum points.   

In an essay of 1500 to 2000 words, using at least 2 APA style cited references, write an essay in APA style on:

1. A 10th grader is brought to you by a teacher. She whispers in your ear to please look at the forearms of the girl because she suspects cutting. What is cutting? Examine the different reasons for cutting. Who in the school could you collaborate with to help the adolescent? Would you call her parents? Her pediatrician? After you have taken care of the situation, the teacher comes back “wanting the scoop”. What do you tell the teacher? Support your answers with legal reasons for or against your answer.
2. You are a middle school nurse. One of the popular jocks on the basketball team committed suicide over the weekend. It is now Monday morning.  Review the mental health considerations of this issue. Synthesize the information and explain what you would do about the mental health issue, what may follow, and the crisis at school.
3. You are part of a committee to prepare a disaster plan for your elementary school. Review your textbook, synthesize the information, and report what your role would be. Of chief concern are your children with chronic illnesses.

Minimum of 300 words with at least 2 peer review reference in 7th edition apa style

 

A 53-year-old male is presenting to you with a 4-week history of low back pain. He does not have an identified traumatic event. He is requesting something for pain. He has history of alcohol abuse but has abstained for 5 years. He has a 25-pack year smoking history and is a current smoker. He takes fluoxetine 20 mg po daily for depression. How would you use the Opioid Risk Tool resource to determine his risk for opioid abuse? How would you counsel him regarding treating his pain?

Question 1

In 200-250 words,  Discuss what resources are often necessary for nonacute care for cardiorespiratory issues. Explain how they support patient independence and decrease readmission. 

Question 2  

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.

2. Denies pain but says she feels like she cannot get enough air.

3. Says her heart feels like it is “running away.”

4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.

2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.

3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.

4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.

5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)

2. Enalapril (Vasotec)

3. Metoprolol (Lopressor)

4. IV morphine sulphate (Morphine)

5. Inhaled short-acting bronchodilator (ProAir HFA)

6. Inhaled corticosteroid (Flovent HFA)

7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.

2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.

3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.

5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.

6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.

7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of TWO sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide.

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 LopesWrite. 

 
Reply 1

Provide two different examples of how research uses hypothesis testing, and describe the criteria for rejecting the null hypothesis. Discuss why this is important in your practice and with patient interactions.

In order to provide examples of uses for hypothesis testing it is important to understand what a hypothesis is. “The hypothesis statements are the blueprint for completing the statistical analysis of the gathered data.” (Ambrose, 2018) Testing a hypothesis evaluates if the prediction made on two variables is valid. Gathering data to show correlations is how you test a hypothesis.

The two examples that came to mind when thinking of a hypothesis in health care are the prediction that washing hands decreases infections and following a specific diet will lead to increased health. “The Null hypothesis indicates the lack of relationship between the variables or that there is no effect on the variables.” (Ambrose, 2018) The criteria to reject a null hypothesis is data proving that the hypothesis is false. When the research is reliable, patterns should occur. When there are patterns, this will permit the researcher to reject the null hypotheses. (Ambrose, 2018) Hypotheses are tested using a one or two tailed testing. (Ambrose, 2018) A one-tailed test is used when the researcher is sure that direction of data will go in a certain way. “A two-tailed test identifies both the positive and negative differences.” (Ambrose, 2018)

As health care professionals, it is important to be able to utilize hypotheses and being able to evaluate them. Nursing interventions and care for patients are products of evidence based practice guidelines, which can be every changing with new research and data. Being able to interpret and utilize these guidelines is important to positive patient care. Nursing improvements and positive patient outcomes can be determined by quality research.

References

Ambrose, J. (2018). Applied Statistics for Health Care. Retrieved from Grand Canyon University: https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/#/chapter/3

Reply 2

 

Predictions of what will happen in a study between two variables is a hypothesis. A hypothesis is needed prior to starting the research to guide the data that is needed to be gathered for the variable. With the data that is collected, research process validates a hypothesis by showing correlation or mutual relationship. Research is always a measure in in a study or understanding differences. “Hypothesis testing is used to establish whether a research hypothesis extends beyond those individuals examined in a single study.” (Laerd, 2018)

One example is two groups of students virtual and in person. The hypothesis could be that in person students did better than virtual students in test taking, showing in person learning is important for the education of school age students. Another example could be that daily zoom meetings or virtual class has a higher classroom average of the students compared to the students who attends zoom virtual classes biweekly. For both, examples the average of test in grades for the sample represents the population.

In health care it shows findings that can be empowered and shows alternative explanations that may or may not be significant without research and hypothesis testing advancements could be detrimental for care of those that need advanced medication or treatment. Sample of 100 breast cancer sufferers depend on research to have new chemotherapy treatment to eradicate cancer more effectively than current treatment type. Consider the process first involved in what your measuring then outlines your structure. This is important for the patients and given opportunity to have treatment that has evidence to work versus medication that has not worked and no evidence to work.

Criteria for rejecting the null hypothesis: “the null hypothesis indicates the lack of relationship between the variables or that there is no effect on the variables.”(Ambrose, 2018) “Data should show patterns, allowing the researcher to reject or fail to reject the null hypothesis.” (Ambrose, 2018) Keep in mind a rejection could be in error. The rejection based on probability results are accurate. If shown effect, null rejected. “A failure to reject the null hypothesis indicates no effect is shown by the evidence.” (Ambrose, 2018) For a null to be rejected, 95% of values need to set close to the mean.

Resources

Ambrose, J. (2018). Applied statistics for health care.Retrieved from https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1