A nurse is taking care of an 85-year-old woman in a hospital-based skilled nursing facility. In the report, the nurse is told the patient has not been breathing well for the past 2 days. She has been lethargic, her skin is warm and dry, and she has a decreased urine output. The following laboratory findings were returned from the laboratory immediately after morning report:

Blood Chemistries

• Na: 147
• Cl: 110
• K: 4.0

Arterial Blood Gases

• pH: 7.33
• PCO2: 48
• HCO3: 27
• PO2: 96

Urinalysis

• Urine Specific Gravity: 1.040

Address the following:

1. Identify each of the abnormal laboratory findings in the above results. Specify how they differ from a normal range and identify what condition each abnormality indicates.
2. What specific electrolyte disturbance does the patient have?
3. What clinical manifestations would the nurse expect to see with this electrolyte abnormality presented above?
4. If the patient had an increase in her potassium level, what clinical manifestations would the nurse monitor for?
5. What blood gas abnormality is seen in this patient? Discuss the rationale for your answer.
6. What are the three major mechanisms of pH regulation?

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

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 Course Reflection Guidelines PURPOSE The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the NUR3178 course. COURSE OUTCOMES This assignment provides documentation of student ability to meet the following course outcomes: – Define complementary and alternative practices as identified by current health paradigms. – Discuss history for complementary and alternative medicine. – Given case studies, describe the extent to which complementary and alternative health practices are encouraged and used among multiple cultures. – Relate concepts into clinical practice. – Analyze the research regarding the efficacy of selected complementary and alternative practices and products. – Integrate alternative therapies within patient’s personal plan of care. POINTS This assignment is worth a total of 100 points (10%). DUE DATE Submit your completed assignment under the Assignment tab by Friday 11:59 p.m. EST of Week 15 as directed. REQUIREMENTS 1. The Course Reflection is worth 100 points (10%) and will be graded on quality of selfassessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric. 2. Follow the directions and grading criteria closely. Any questions about your essay may be posted under the Q & A forum under the Discussions tab. 3. The length of the reflection is to be within three to six pages excluding title page and reference pages. 4. APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered): Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63). a. Course Reflection b. Conclusion 

PREPARING YOUR REFLECTION The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for the BSN-prepared nurse. Reflect on the NUR3178 course readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:

 1. “Apply leadership concepts, skills, and decision making in the provision of highquality nursing care, healthcare team coordination, and the oversight and accountability for care delivery in a variety of settings. 

2. Demonstrate leadership and communication skills to effectively implement patient safety and quality improvement initiatives within the context of the interprofessional team.  Florida National University NUR3178 NUR3178 Course Reflection Guidelines.docx 08/21/19 2  

3. Demonstrate an awareness of complex organizational systems. 

4. Demonstrate a basic understanding of organizational structure, mission, vision, philosophy, and values. 

5. Participate in quality and patient safety initiatives, recognizing that these are complex system issues, which involve individuals, families, groups, communities, populations, and other members of the healthcare team. 

6. Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions and describe the process of changing current practice. 

7. Promote factors that create a culture of safety and caring. 

8. Promote achievement of safe and quality outcomes of care for diverse populations. 

9. Apply quality improvement processes to effectively implement patient safety initiatives and monitor performance measures, including nurse-sensitive indicators in the microsystem of care. 

10. Use improvement methods, based on data from the outcomes of care processes, to design and test changes to continuously improve the quality and safety of health care. 

11. Employ principles of quality improvement, healthcare policy, and cost-effectiveness to assist in the development and initiation of effective plans for the microsystem and/or systemwide practice improvements that will improve the quality of healthcare delivery. 

12. Participate in the development and implementation of imaginative and creative strategies to enable systems to change. 

13. Compare/contrast the roles and perspectives of the nursing profession with other care professionals on the healthcare team (i.e., scope of discipline, education and licensure requirements). 

14. Use inter and intraprofessional communication and collaborative skills to deliver evidence-based, patient centered care. 

15. Incorporate effective communication techniques, including negotiation and conflict resolution to produce positive professional working relationships. 

16. Contribute the unique nursing perspective to interprofessional teams to optimize patient outcomes. 

17. Demonstrate appropriate teambuilding and collaborative strategies when working with interprofessional teams. 

18. Advocate for high quality and safe patient care as a member of the interprofessional team.” (AACN, 2008, pp.14,22). Reference: American Association of Colleges of Nursing [AACN]. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.