1. Competency
   Describe strategies for safe, effective multidimensional nursing care for clients with acid-base imbalances.

   Scenario
   Tony is a 56-year-old, Hispanic male that presented to the Emergency Room with complaints of shortness of breath, which he has been experiencing for the past two days. He states “I haven’t felt good for about a week, but couldn’t afford to miss work.” He complains of a cough, fever, and feeling exhausted. Past medical history includes asthma, chronic obstructive pulmonary disease and diabetes. Upon physical examination, you notice that Tony is struggling to breathe, his respiratory rate is 36 breaths per minute and labored, heart rate 115 beats per minute, blood pressure 90/40 mm Hg, and his pulse oximetry is 84% on room air. You notify the MD. He orders oxygen at 2 L via NC and an arterial blood gas.

   Tony’s ABG results:
   pH 7.28
   PaCO2 – 55 mm Hg
   PaO2 – 70 mm Hg
   HCO3 – 30 mEq/L

   Instructions
   In a 1-2 page Word document:

   1. Determine Tony’s acid-base imbalance
   2. Describe possible causes of the imbalance
   3. Identify the signs and symptoms that Tony is exhibiting as a result of the acid-base imbalance
   4. List the multidimensional care strategies that are appropriate for the care of Tony
   5. Resources
      For assistance with citations, refer to the APA Guide.
      For assistance with research, refer to the Nursing Research Guide.
      Submit your completed assignment by following the directions below. Please check the Course Calendar for specific due dates.
      Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:
      Jstudent_exampleproblem_101504

 

Purpose 

The purpose of this discussion is to discuss organizational changes and ethical-legal influences in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and ethical and legal implications for members of the heath care team as a result of illegal behaviors.  Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture. 

Activity Learning Outcomes 

Through this discussion, the student will demonstrate the ability to: 

1. Demonstrate effective leadership styles in the management of organizational change (CO3) 
2. Interpret various forms of ethical theories and application into practice (CO4) 
3. Discuss practice guidelines and malpractice prevention (CO2) 

Requirements: 

You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers. 

Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice. 

Case Study Questions: 

1. What are the potential ethical and legal implications for each of the following practice members? 
   • Medical assistant 
   • Nurse Practitioner 
   • Medical Director 
   • Practice 
2. What strategies would you implement to prevent further episodes of potentially illegal behavior? 
3. What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.
4. A scholarly resource must be used for EACH discussion question each week.

 

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal

The benchmark assesses the following competency:

4.2 Communicate therapeutically with patients.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Note:  The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

Select one of the following as the focus for the teaching plan:

1. Primary Prevention/Health Promotion
2. Secondary Prevention/Screenings for a Vulnerable Population
3. Bioterrorism/Disaster
4. Environmental Issues

Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.

1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.
2. Request feedback (strengths and opportunities for improvement) from the provider.
3. Complete the “Community Teaching Experience” form with the provider. You will submit this form in Topic 5.

Prepare this assignment according to the 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

AttachmentsNRS-428VN-RS3-CommunityTeachingWorkPlanProposal.docx 

Choose a contemporary moral issue in our society and apply the ethical principle of Utilitarianism to approve this moral issue. You must pick a moral issue that you strongly support and apply the utilitarian claims to back up your arguments. The paper must be done in MLA format with a minimum of 500 words (quotes are not included in the word count.

****You must apply Bentham’s “Principle of Utility” and the Four major points of Utilitarianism *****

“Read Chapter 2 of the book”

I need a Turnitin report. 

 

The Individual EBP Assignment requires the learner to find an EPB article that relates to the topic and group project problem. below you find documents to help you with this assignment:

EBP Article Analysis Guideline.docx
Exemplar.EBP.docx

TOPIC: PATIENTFAMILY-CENTERED CARE

• First review the group project problem and title.
• Use keywords from your problem for your lookup inquiry. i.e. infection control, nurse, retention, etc. 
• Use EBP articles no more than 5 years old. 
• Make sure you put your name at the top and include your article citation in 7th ed. APA format of your assignment – see exemplar. 
• There are prompts in the left column to assist you. 
• Do not give research terms on your assignment i.e. this is a cross-sectional study or has validity unless you’re ready to explain how this will help you solve your problem. These terms are used so that you know if an article is valid and reliable. OK, so now that you found this, your job is to find out how this project will help you solve your problem. 
  • The paper is set up to determine the strength, weaknesses, opportunities, and threats of the project itself. 
  • By answering these questions, you will help guide and collaborate with your peers with constructive feedback on how to solve your problem collectively as a team.
    • Strength – Example: Did they have the support of the peers, manager, CEO. Did this project improve patient satisfaction, quality, efficiency? Usually found in the literature review and results.
    • Weakness – Example: This is the opposite. Why was this plan weak: Not enough education, no support, not enough money because of the expense? Usually found in the problem of the literature review, results, and limitations.
    • Opportunity – Example: If there wasn’t enough education, is this an opportunity? A better survey or tool? Usually found in results or limitations and future implications.
    • Threat – Example: Increased infection, possible death, etc. Usually found in the literature review. 
  • It is your job to know your article and have the ability to articulate what your article is about with your peers and with your instructor. 
  • During the virtual class, you may be asked to elaborate on your article. So know your article! 
• Please note that the exemplar provided received maximum points. 
• Submit both the Assignment and Article in the BrightSpace Assignment submission folder.