ETHICS 2025

This week students will be completing a narrated power point to discuss one of the following cases. Lisa McPherson Clearwater, Florida (1995) Terri Schiavo St. Petersburg, Florida (1990–2005) Nadya Doud-Suleman Bellflower, California (January 2009) Elodie Irvine v. Regents of the University of California 57 Cal.Rptr.3d 500, 149 Cal.App.4th 994 (2007) Court of Appeal State of California, Fourth Appellate District Division Three First, students should pick one of the ethical cases above and create a power point presentation to address the following: What are the facts of the case? This should include: what do we need to know, who is involved in the situation, where does the ethical situation take place, and when does it occur? (3-4 slides) What is the precise ethical issue in regards to autonomy, nonmaleficence, beneficence, fidelity, and justice? (5-6 slides) Identify the major principles, rules, and values of the case. Values are sets of beliefs about good and bad, right and wrong, and about many other aspects of living and interacting in the society with others. A principle is a personal rule that governs personal behavior. A rule is generally imposed by a figure of authority, and used to guide and govern people. (3-5 slides) Is there legal ground for this case, state what they are? Who is at fault? What legal action should be taken? (2-4 slides) Are there alternative to the actions completed in this case by the parties involved? What could have been done to prevent the outcome of the case? (3-6 slides) If you were a member of the ethics committee at the facility the event happened, what action would you take in this case? (2-4 slides) As a healthcare professional, how did the outcome of the case make you feel? Does it align with your personal values and beliefs? Would caring for this patient be difficult? How do you separate your personal beliefs when completing your job? (4-6 slides) For the presentation, insure information is referenced and cited in your slides. The presentation should start with a title slide and end with a reference slides. At least 3 references are required for this assignment. If you include pictures, your pictures should also be referenced and cited. Now students will add the narrative to their power point using one of the following tools. VoiceThread ( http://voicethread.com/ ) – VoiceThread allows you to upload, share and discuss documents, presentations, images, audio files and videos (over 50 different types of media can be used in a VoiceThread). Within the presentation, you can comment on VoiceThread slides using one of five options: Microphone, webcam, text, phone, and audio-file upload. VoiceThreads can be used to create microlectures by: Narrating a PowerPoint presentation Discussing a journal article Annotating a website or document Reviewing a picture or graphic For detailed information on how to use VoiceThread to create microlectures, see: Written instructions: http://www.asu.edu/courses/tconline/Include/VoiceThread%20Instructions.htm Video tutorial: https://youtu.be/2jVW_aAyGPE Screencast-o-Matic ( http://www.screencast-o-matic.com/ ) – Screencast-o-Matic is a program that allows for one-click screen capture recording. Not only does Screencast-o-Matic record all the activities on your computer screen, but it allows you to simultaneously record your voice as the narration to support your screen capture recording. Screencast-o-Matic is great for: Narrating PowerPoint lectures (i.e., create lectures for your online courses) Demonstrating website navigation (i.e., create how-to videos for using the library or a required web-based activity) Demonstrating software application (i.e., create videos demonstrating how to run an analysis in SPSS) Course overview tutorials (i.e., provide students with a visual tour of your online course) Syllabus overview tutorials (i.e., create a video walking students through the requirements of your course) For detailed information on how to use Screencast-o-Matic to create engaging course supplements, see: Written instructions: http://aohs.ua.edu/cm/general/screen_o_matic.pdf Video tutorial: https://youtu.be/jADJ_OoSnm8 Assignment Expectations: Length: 15 to 20 slides, and 8-15 minutes in length Use the tips at http://www.garrreynolds.com/preso-tips/design/ to create the slideshow. Because good PowerPoints have very few words, submit a script that describes the content of each slide – about 50 words per slide. Place this script in a separate Word document that shows each slide number and the text for each slide as shown in the provided PowerPoint Slide Notes.docx . Structure: Include a title page and reference page in APA style References: References are required. You should include the appropriate APA style in-text citations and references for all resources utilized to answer the questions. You must include at least 5 pictures or graphics. All pictures or graphics taken from outside sources must be referenced and cited. Format: save your assignment as a Microsoft PowerPoint (.ppt or .pptx) File name: name your saved file according to your last name, first initial and the week (for example, “jonesb.week1”)

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Discussion: Assessing the Heart, Lungs, and Peripheral Vascular System 2025

I need 1 reply comment to each post with a credible sources, citation and years above 2013 in APA format. Post 1 CHIEF COMPLAINT: Shortness of Breath and cough Subjective: Pt presents with complaints of shortness of breath and productive cough. Pt relates he is coughing up thick green sputum with occasional bloody sputum. Pt relates that he has increased shortness of breath with walking. Patient relates that he is also short of breath at rest. Pt also relates that he has had some chills and sweats and felt like he may have a fever. He states that he has taken Tylenol for those symptoms. Objective: Temperature 100.9, Respiratory rate 20, Heart rate 82, Blood pressure right arm 128/70, Oxygen saturation 89% on room air, Weight 210 pounds, EKG shows normal sinus rhythm, Chest radiograph Assessment: Skin is warm and moist. Thorax is symmetrical with diminished breath sounds with rales and expiratory wheezes throughout, negative for rhonchi. Wet productive cough noted during exam. Heart is regular sinus rhythm with rate of 82. Good S1, S2; negative S3 or S4 and negative for murmur. Abdomen protuberant with normoactive bowel sounds auscultated in all four quadrants. No pedal edema noted. 2+ dorsalis pedis pulses bilaterally. Neurologic: Patient is awake, alert and oriented to person, place and time. Chest radiograph shows infiltrate in the right middle lobe. Priority diagnosis includes 1. Pneumonia 2. Myocardial Infarction 3. Pulmonary embolism  4. Congestive Heart Failure 5. Asthma 1. Pneumonia: The patient presents with productive cough and shortness of breath with exertion. Patient has elevated temperature and low oxygen saturations along with diminished breath sounds, rales and expiratory wheezes which are all consistent symptoms with community acquired pneumonia. (Lynn, 2017). Chest radiograph shows right middle lobe infiltrate which is also consistent with pneumonia. (Kaysin and Viera, 2016). 2. Myocardial Infarction: The patient presents with shortness of breath and low oxygen saturations. Pt states that his shortness of breath is worse with exertion but is present at rest also. Dyspnea is a frequent associated symptom with MI. (Lawesson, Thylen, Ericsson, Swahn, Isaksson and Angerud, 2018). The patient did have an EKG completed that revealed a normal sinus rhythm at a rate of 80 with no obvious signs of ectopy. Evaluation of troponin level would assist in ruling out MI as a diagnosis for this patient. (Berliner, Schneider, Welte and Bauersachs, 2016). 3. Pulmonary Embolism: Dyspnea is the primary symptom for patients with PE. (Garcia-Sanz, Pena-Alvarez, Lopez-Landeiro, Bermo-Dominguez, Fonturbel and Gonzalex-Barcala, 2014). Onset of dyspnea with PE is typically sudden and further history for this patient related to onset of symptoms. Evaluation of any extremity pain and swelling, D-dimer or chest angiography would also assist in determining if this was a more likely diagnosis. (Berliner, Schneider, Welte and Bauersachs, 2016). 4. Congestive Heart Failure: Dyspnea is also a common symptom with congestive heart failure. Fatigue, diminished exercise tolerance and fluid retention are also common symptoms of CHF. (Berliner, Schneider, Welte and Bauersachs, 2016). The patient has rales noted upon auscultation which could be consistent with congestive heart failure however coupled with the remainder of the exam including productive cough with thick green sputum and fever, CHF would not be the primary diagnosis. Further evaluation of extremities of abdomen and extremities for signs of fluid retention would be indicated as well as labs such as BNP. 5. Asthma: The patient has expiratory wheezes and shortness of breath which are both consistent with asthma; however the patient also has fever and productive cough which are not consistent asthma symptoms. (Huether and McCance, 2017). Plan : Not indicated References Arcangelo, V. P., Peterson, A. M., Wilbur, V. & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby. Berliner, D., Schneider, N., Welte, T., & Bauersachs, J. (2016). The Differential Diagnosis of Dyspnea. Deutsches Aerzteblatt International , 113 (49), 834. doi:10.3238/arztebl.2016.0834 Debasis, D., & David C., H. (2009). Chest X-ray manifestations of pneumonia. Surgery Oxford , (10), 453. doi:10.1016/j.mpsur.2009.08.006 Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby. García-Sanz, M., Pena-Álvarez, C., López-Landeiro, P., Bermo-Domínguez, A., Fontúrbel, T., & González-Barcala, F. (2014). Original article: Symptoms, location and prognosis of pulmonary embolism. Revista Portuguesa De Pneumologia , 20 194-199. doi:10.1016/j.rppneu.2013.09.006 Post 2 S: Chief Complaint: “I am having chest pain at this time” History of Present Illness: Pleasant, Caucasian male experiencing an acute onset of sharp, constant chest pain when taking a deep breath. Denies any alleviating factors. Yesterday his wife noticed his RT leg was edematous with erythema, denies any injury. Recently he returned from a vacation with an 8-hour plane ride. The patient was not asked if his pain radiated or if he had nausea or dizziness. Past Medical History: Denies taking any medications. Allergies, surgeries, past medical conditions “not provided.” History of cancer or deep vein thrombosis not provided. Social History: Married Review of symptoms: General: Feels short of breath when taking a deep breath, also having sharp lower RT rib pain. Cardiovascular: Experiencing tachycardia. Peripheral edema started yesterday in RT lower leg. Pulmonary: Reports having sharp pain when taking a deep breath with no relief measures noted. Complains of dyspnea with productive hemoptysis cough this morning. Gastrointestinal: “not provided.” O: VS: BP 148/88 RT arm; P 112 and irregular; R 32 and labored; T 97.9 orally; Pulse Ox 90% on RA; His current weight is stable at 210 pounds. General: Well-nourished, a well developed Caucasian male who is alert and cooperative. He is a good historian and answers questions appropriately. Patient sitting upright at the side of the cot appears anxious with labored breathing. Guarding noted in the anterior, distal RT rib area. Cardiovascular: Skin is pallor, cool and diaphoretic. Heart rate is tachycardic. S1 and S2 irregular with no S3, S4, or murmur auscultated. RT calf with erythema, 2+ edema, warmth, and tender with palpation. LT leg with no edema, tenderness, or erythema noted. Bilateral 2+ dorsalis pedis pulse. Telemetry showing a sinus arrhythmia. Gastrointestinal: Protuberant abdomen with active bowels x 4 quadrants. Pulmonary: LT Lung clear to auscultation, RT middle and lower lobes with diminished breath sounds. No rales, rhonchi, or wheezing auscultated. Respirations labored. Respiratory excursion symmetrical. Diagnostic results: CXR, ECG, venous doppler studies and ultrasound for DVT, V/Q scan, CT of the chest, labs- sputum culture, cardiac enzymes. Telemetry. A: Differential Diagnosis: 1.) Pulmonary Embolism 2.) Pneumonia 3.) Lung Cancer 4.) Myocardial Infarction 5.) Cardiac Arrythmia P: “not required” Evidence and Justification of Differential Diagnosis and Diagnostic Tests Gruettner J. et al. (2015) report the Wells risk score assesses the history of a previous DVT or PE in a patient. Assessment of tachycardia, recent surgeries or immobilization, observation of DVT signs, an alternative diagnosis less likely than pulmonary embolism, hemoptysis, and cancer are gathered. Each area is assigned a score and the calculated total score interprets the probability of having a pulmonary embolism. The patient calculated score indicated a pulmonary embolism even though the history of cancer was unknown. The diagnostic test of a CT angiography was found to be successful in the diagnosis of a pulmonary embolism with Gruettner J. et al. (2015) research. The D-dimer, ABG, EKG, and computed tomography showed little value in the diagnosis (Gruettner J. et al., 2015). Dains, J. E., Baumann, L. C., & Scheibel, P. (2016) indicate pneumonia causes the

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Microbiology day nine assignment 2025

Answer Clinical Application Questions 1-3 for Chapter 21 on page 614 and Clinical Application Question 1-3 for Chapter 22 on page 642. Answers should be submitted in a word document with any associated references used. Answer Clinical Application Questions 1-3 for Chapter 21 on page 614 1) A hospitalized patient recovering from surgery develops an infection that has blue-green pus and a grapelike odor. What is the probable etiology? How might the patient have acquired this infection? 2) A 12-year old diabetic girl using continuous subcutaneous insulin infusion to manager her diabetic developed a fever (39.4 degree C), low blood, abdominal pain, and erythroderma. She was supposed to change the needle-insertion site every 3 days after cleaning the skin with an iodine solution. Frequently she did not change the insertion site more often than every 10 days. Blood culture was negative, and abscesses at insertion sites were not cultured. What is the probable cause of her symptoms? 3) A teenage male with confirmed influenza was hospitalized when he developed respiratory distress, He had a fever, rash, and low blood pressure. S. aureus was isolated from his respiratory secretions. Discuss the relationship between his symptoms and the etiological agent Clinical Application Question 1-3 for Chapter 22 on page 642. 1) A 1-year-0ld infant was lethargic and had a fever. When admitted to the hospital , he had multiple brain abscesses with gram-negative coccobacilli. Identify the disease, etiology, and treatment. 2) A 40-year-old bird handler was admitted to the hospital with soreness over his upper jaw, progressive vision loss, and bladder dysfunction. He had been well 2 months earlier. Within weeks he lost reflexes in his lower extremities and subsequently died. Examination of CSF showed lymphocytes. What etiology do you suspect? What further information do you need? A normal baby gained weight appropriately for 12 weeks. Then she stopped feeding. Her right eardrum was inflamed, she had a stiff neck, and her temperature was 40 degree C. Examination of CSF revealed Gram-negative coccobacilli. Identify the disease and treatment

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Prioritization Discussion 2025

Week 3: Prioritization Discussion Case Study Review the following Prioritization Principles videos: Prioritization https://www.youtube.com/watch?v=WRElSFt674M (Links to an external site.) Nursing Leadership – ABCDE Principle and Patient Prioritization https://www.youtube.com/watch?v=hWTKT4Z1ae0 (Links to an external site.) Nursing Leadership – Efficient Nursing Practice & Delegation https://www.youtube.com/watch?v=iI4HIZpScPQ (Links to an external site.) Maslow’s Hierarchy of Needs as it relates to Prioritization Introduction: Setting priorities is an essential and critical thinking skill. Priority setting is perhaps the most critical skill in good time management, because all actions we take have some type of relative importance. Management of a patient load depends heavily on setting priorities. Generally, the new nurse tends to focus on one problem at a time rather than seeing the whole picture and may have difficulty in priority setting. Through the assessment process, patients help the nurse define their needs, establish interventions, and implement the plan of care. This is where individualized priority-setting between patients and nurses occurs. By necessity some care needs will be delayed in preference to more pressing needs of other patients. Priorities will be influenced by the acuity of the patient’s condition and the acuity of all patient’s assigned to a nurse Time Management: Three Basic Steps in Time Management Allow time for planning and establish priorities. Complete the highest priority task whenever possible, and finish one task before beginning another. Reprioritize based on the remaining tasks and on new information that may have been received. Priority ranking of patients: First level patient problem These are threats to a patient’s immediate survival or safety and demand immediate nursing intervention. ABC’s (airway, breathing, circulation). Second level patient problem Concerns such things as mental status change, acute pain, acute urinary elimination, untreated medical problems requiring immediate attention (diabetic needing insulin) abnormal pathology lab results, risks of infection, safety, or security. Third level patient problem Those that do not fit into the above two categories such as monitoring for medication side effects, lack of patient knowledge, longer patient longer-term problems with living activities, etc. No life-threatening problems exist The nurse used both professional judgment and the patient to set priorities and determine planning. This is a continually changing aspect of assessment of patients. Priority Setting Traps: “Whatever hits first” This trap occurs when an individual simply responds to things as they happen rather than thinking first and then acting. This is common to new nurses. “Path of least resistance” In this trap the individual makes the assumption that it is easier to do a task by himself or herself and fails to delegate appropriately. “Squeaky wheel” In this trap, the individual falls prey to those who are most vocal about their requests and then feels a need to respond to the time frame imposed by the ““squeaky wheel” rather than his or her own. “Default” The individual feels obligated to take on tasks that no one else has come forward to do. “Inspiration” In this trap, individuals wait until they become “inspired” to accomplish a task. Some tasks will never be inspiring, and the wise time manager recognizes that the only thing that will complete these tasks is hard work and appropriate attention to the matter. Managing time at work: Being overwhelmed by work and time constraints lead to increased errors, omission of important tasks, and general feelings of stress and ineffectiveness. Time management skills are learned although some people are better at it than others. Disorganization results from poor planning and prioritization. Simple suggestions for time management: Gather all the supplies and equipment that will be needed before starting an activity. Breaking down a job mentally into parts before beginning the activity may help the nurse identify what supplies are needed. Group or “cluster” activities that are in the same location. If you have walked a long distance down a hallway, attempt to do several things there before going back to the nurses station. Another example is a home health nurse, group client visits geographically when possible to minimize travel time. Document your nursing interventions as soon as possible after an activity is completed. Waiting until the end of the workday to complete necessary documentation increases the risk of inaccuracies and incomplete documentation. Strive to end the workday on time. Although this is not always possible, delegating appropriately to others and making sure that the workload goal for any given day is reasonable are two strategies that will help accomplish this goal. Schedule difficult tasks during the period of the day you are most productive and simpler, more routine tasks during less productive times. Time wasters: Procrastination The three most common reasons for procrastination are: Not wanting to begin Not knowing where to begin Not knowing where to begin, even if you wanted to do, which you don’t. Poor planning Failure to establish goals and objectives Inability to delegate Inability to say no Management by crisis Haste Indecisiveness Coping with short short-staffing: Prioritize you assignments Organize your workload Be a team player Make a rule that no one can sit until everyone can sit. Pitch in and help others. Use unlicensed personnel wisely Encourage family participation Inform and involve nursing administration Communicate effectively and nicely Take care of yourself Maintain a positive attitude Attitude is everything. If you go into a is challenging situation with a positive attitude you can achieve great results. A negative attitude can bring down the morale and performance of the entire team. Scenario: Assume that you are the Charge Nurse of a team with one LPN and one nursing assistant on the 7A-3P shift at an acute care hospital. The three of you are responsible for providing total care to 10 patients. Prioritize the following list of 10 things you need to accomplish this morning. Use a 1 for the first thing you will do and a 10 for the last. ________ Check MAR against the orders ________ Listen to night shift report from 0700-0720 ________ Perform walking rounds to assess the night shift report and to introduce yourself to patients. ________ Hang four (4) 0900 IV medications ________ Set up the schedule for breaks and lunch among your team members ________ Give the 0845 pre-op on patient going to surgery at 0900 ________ Pass the 0830 breakfast trays ________ Read the charts on new admissions that you are responsible for on the unit ________ Check 0600 blood glucose results for 0730 insulin administration ________ Consult with the interdisciplinary healthcare team to develop and/or revise patient plans of care Now, create an initial discussion posting that provides the rationale for how your prioritized your day in relation to Maslow’s Hierarchy of Needs. Your initial posting must be completed by Wednesday, 3/17/2021 by 11:59 pm. On another day, you must respond to two of your classmates by Sunday, March 21/2021 by 11:59 pm. References: Hägg-Martinell, A., Hult, H., Henriksson, P., & Kiessling, A. (2020). Nursing Students Learn to Handle Stress and to Prioritize in a Complex Context During Workplace Learning in Acute Internal Medicine Care – An Ethnographic Study. Advances in medical education and practice , 11 , 21–30. https://doi.org/10.2147/AMEP.S230476 Toney-Butler TJ, Thayer JM. Nursing Process. [Updated 2020 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. [Figure, Maslow’s Hierarchy of Needs for…] Available from: https://www.ncbi.nlm.nih.gov/books/NBK499937/figure/article-26037.image.f1/

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