Week 4 discussion 2025

Apply information from the Aquifer Case Study to answer the following discussion questions: Discuss the Mrs. Gomez’s history that would be pertinent to her difficulty sleeping. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know. Describe the physical exam and diagnostic tools to be used for Mrs. Gomez. Are there any additional you would have liked to be included that were not? Please list 3 differential diagnoses for Mrs. Gomez and explain why you chose them. What was your final diagnosis and how did you make the determination? What plan of care will Mrs. Gomez be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?

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PICOT STATEMENT 2025

Review the Topic Materials and the work completed in NRS-433V to formulate a PICOT statement for your capstone project. A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process. Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project. In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome. Make sure to address the following on the PICOT statement: Evidence-Based Solution Nursing Intervention Patient Care Health Care Agency Nursing Practice 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. Please refer to the directions in the Student Success Center. attached is my PICOT statement you can use to develop a paper

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cases study 2025

CASE STUDIES I- Case Study: Care of the Child in Inpatient and Outpatient Settings Jordan is 9-year-old male who is a direct admit for observation. He has a history of vomiting and diarrhea for 48 hours. Subjective Data Nausea and vomiting for 24 hours Has not voided today Unable to tolerate oral fluids Objective Data Vital signs: T 37.8° C, P 120, R24, BP 110/60 Weight: 34 kg Hyperactive bowel sounds to auscultation 1. Question 1 When should the discharge teaching begin for Jordan and his family? 2. Question 2 What is the best way to approach Jordan regarding the IV that has been ordered. 3. Question 3 What would be good distractions for a child of Jordan’s age? II- Case Study: Pediatric Cancer Mario is a 7-year-old male who presents with a 1-week history of body aches and pallor. He has a 2-day history of fever to 103° F and a 1-day history of bruising and lethargy. Subjective Data Complains of hurting all over States he feels very tired States he feels dizzy when he stands up Objective Data Weight 26.1 kg Vital signs: T 38.9° C, P 140, R 40, BP 108/54, O2 sat 100% Purpural rash on extremities WBC 0.7 HGB 3.1 Hct 8.5 Plt .08 ANC 0.1 4. Question 1 Which of Mario’s presenting symptoms must be treated and stabilized before chemotherapy induction? 5. Question 2 What testing is required for a definitive diagnosis of meningitis? 6. Question 3 What should the nurse do in this clinical situation? Prioritize actions. III- Case Study: Pediatric Respiratory System Will is a 4-month-old infant born at 34 weeks of gestation. Will’s mother states that he has not been able to go to day care because he has been coughing with a fever for the past 3 days. She states today he is unable to feed well from the bottle because of nasal secretions. Subjective Data Mother complains that infant has had cough for 3 days Mother states that infant is having trouble sleeping Not voided in past 6 hours Objective Data Birth Weight: 1.9 kg Today’s Weight: 5.5 kg Vital Signs: T 38° C, P 186, R 60, BP 90/52, Pulse Oximetry 93% Thick yellow nasal secretions Nasal flaring with moderate intercostal retractions Breath sounds decreased with crackles bilaterally to auscultation 7. Question 1 What risk factors does Will have for contracting bronchiolitis? 8. Question 2 What is the first priority for Will’s treatment? 9. Question 3 What should the nurse do in this clinical situation? Prioritize actions. IV- Case Study: Pediatric Gastrointestinal System Lucy is a 44-day-old formula-fed infant who presents with a 4-day history of vomiting. Subjective Data Mother states infant has been vomiting undigested formula after feedings Mother states that infant has not had fever or diarrhea Mother states that infant has had 8 wet diapers in the past 24 hours Objective Data Weight 4.8 kg (birth weight 3.5 kg) Vital signs: T 37.1° C (rectal), P 130, R 30, BP 92/52 Mucous membranes moist, anterior fontanel flat and soft Awake and alert, lusty cry Good muscle tone Olive-sized mass palpated at epigastrium 10. Question 1 What test will be used to diagnose pyloric stenosis? 11. Question 2 What should the nurse do in this clinical situation? Using the case study above, the first prioritization step the nurse would take is ____. 12. Question 3 The second prioritization step the nurse would take is ____. 13. Question 4 The third prioritization step the nurse would take is ____. 14. Question 5 The fourth prioritization step the nurse would take is ____. 15. Question 6 The fifth prioritization step the nurse would take is ____. 16. Question 7 The sixth prioritization step the nurse would take is ____. 17. Question 8 The seventh prioritization step the nurse would take is ____. 18. Question 9 The eighth prioritization step the nurse would take is ____. V- Case Study: Pediatric Cardiovascular System Michael is a 7-week-old breastfed infant who presents with a 2-day history of irritability and poor feeding. Subjective Data Mom states patient has been “fussy” for past 2 days Only feeds for a “few” minutes at a time Breathing heavily and fast for 2 days Objective Data Weight: 4.8 kg Vital Signs: T 36.8° C, P 250, R 65, BP 84/58 Breath sounds clear to auscultation Oxygen Saturation 95% Central capillary refill 4 sec 19. Question 1 What is the treatment for an unstable patient with SVT? 20. Question 2 Decreased cardiac output from prolonged SVT will produce what complication? 21. Question 3 In this clinical situation what should the nurse do? Prioritize actions. VI- Case Study: Hematologic System Liam is an 8-year-old male with a history of hemophilia. Liam presents today with a 1-day history of right elbow pain. Subjective Data Right elbow pain for 1 day Patient states he hit his right elbow on desk yesterday Patient complains that he cannot move his elbow Objective Data Weight 31.6 kg Vital sighs: T 37.4° C, P 82, R 20, BP 108/68 Rates pain 6 on scale of 10 22. Question 1 How should the nurse respond when Liam’s father explains that they watched and waited to see if Liam needed treatment after his injury? 23. Question 2 Why are neuro checks an important part of Liam’s physical exam? 24. Question 3 What should the nurse do in this clinical situation? Prioritize actions. VII- Case Study: Common Disorders of the Red Blood Cells Susan is a 26-year-old G1P0 at 6 weeks of gestation with type 2 diabetes. Her BMI is 32. Her hemoglobin A1C is 9. She uses glyburide 10 mg PO daily. The physician has switched her to insulin at this time. 1. Question 1 What is the nursing priority at this time? 2. Question 2 What should Susan be taught about insulin needs during pregnancy? 3. Question 3 What additional risk factor does Susan have? 4. Question 4 How should Susan be counseled regarding weight gain in pregnancy? 5. Question 5 What advice can be given to Susan regarding exercise? VIII- Case Study: Pediatric Genitourinary System Lilly is a 3-year-old female who presents with complaints of abdominal pain and fever since yesterday. Subjective Data Complains of lower abdominal pain Fever for 24 hours Lilly has ‘wet her pants’ despite being recently potty trained Objective Data Vital signs: T38.5° C, P 114, R 32, BP 104/62 Urine positive for WBCs, nitrites, blood 6. Question 1 What risk factors does Lilly have for UTI? 7. Question 2 What might prevent Lilly from a recurring UTI? 8. Question 3 What should the nurse do in this situation? Prioritize actions. IX- Case Study: Pediatric Neurologic System Abby is a 1-year-old female who presents after a reported seizure at day care. Subjective Data Fever for 1 hour Eating and drinking normally per mother Objective Data Vital signs: T 40° C, HR 160, R 44, BP 104/68 Awake and alert Skin hot to touch, otherwise normal physical examination 9. Question 1 How should the nurse respond to Abby’s mother when she asks if Abby has epilepsy? 10. Question 2 How should the nurse respond to Abby’s mothers question about brain damage? 11. Question 3 In this clinical situation what should the nurse do?

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Benchmark – Electronic Health Record Implementation 2025

Benchmark – Electronic Health Record Implementation Paper This benchmark assignment assesses the following programmatic competencies: 2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care. 5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care. One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process. In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse’s role during this type of scenario: 1) What key information would be needed in the database that would allow you to track opportunities for care improvement? 2) What role does informatics play in the ability to capture this data? 3) Which systems and staff members would need to be involved in the design and implementation process and team? 4) What professional, ethical, and regulatory standards must be incorporated into the design and implementation of the system? 5)How would the EHR team ensure that all order sets are part of the new record? 6) How would you communicate the changes, including any kind of transition plan? 7) What measures and steps would you take to evaluate the success of the EHR implementation from a staff, setting, and patient perspective? 8) What leadership skills and theories would facilitate collaboration with the interprofessional team and provide evidence-based, patient-centered care? You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. 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.

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Evidence-Based Project, Part 4: Critical Appraisal of Research 2025

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers. Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action. In this Assignment, you will use appraisal tools to conduct a critical appraisal of published research. You will then present the results of your efforts. To Prepare: Review the Resources and consider the importance of critically appraising research evidence. Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3. Review and download the Critical Appraisal Tools document provided in the Resources. The Assignment (Evidence-Based Project) Part 4A: Critical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tools document. Be sure to include: An evaluation table A levels of evidence table An outcomes synthesis table Part 4B: Critical Appraisal of Research Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research. Resources: Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer. Chapter 5, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 124–188) Chapter 6, “Critically Appraising Qualitative Evidence for Clinical Decision Making” (pp. 189–218) Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association, 15 (3), 202–207. doi:10.1177/1078390309338733. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1022.62&rep=rep1&type=pdf Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010a). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. American Journal of Nursing, 110 (7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2010/07000/Evidence_Based_Practice_Step_by_Step__Critical.26.aspx Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Critical appraisal of the evidence: Part II: Digging deeper—examining the “keeper” studies. American Journal of Nursing, 110 (9), 41–48. doi:10.1097/01.NAJ.0000388264.49427.f9. Retrieved from https://www.nursingcenter.com/nursingcenter_redesign/media/EBP/AJNseries/Critical2.pdf Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010c). Evidence-based practice, step by step: Critical appraisal of the evidence: Part III: The process of synthesis: Seeing similarities and differences across the body of evidence. American Journal of Nursing, 110 (11), 43–51. doi: 10.1097/01.NAJ.0000390523.99066.b5. Retrieved from https://www.nursingcenter.com/nursingcenter_redesign/media/EBP/AJNseries/Critical3.pdf ical2.pdf Rubric: Part 4A: Critical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tools document. Be sure to include: · An evaluation table · A levels of evidence table · An outcomes synthesis table– Levels of Achievement:Excellent 45 (45%) – 50 (50%) The critical appraisal accurately and clearly provides a detailed evaluation table. The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected. The critical appraisal accurately clearly provides a detailed levels of evidence table. The levels of evidence are accurate and fully aligned to the peer-reviewed articles selected. The critical appraisal accurately and clearly provides a detailed outcomes synthesis table. The outcomes synthesis accurately describes in detail the relevance of the peer-reviewed articles selected and is fully aligned to each of the peer-reviewed articles.Good 40 (40%) – 44 (44%) The critical appraisal accurately provides an evaluation table. The responses provide an accurate evaluation of each of the peer-reviewed articles selected with some specificity. The critical appraisal accurately provides a levels of evidence table. The levels of evidence are accurate and are adequately aligned to the peer-reviewed articles selected. The critical appraisal accurately provides an outcomes synthesis table. The outcomes synthesis accurately describes the relevance of the peer-reviewed articles selected and is adequately aligned to each of the peer-reviewed articles.Fair 35 (35%) – 39 (39%) The critical appraisal provides an evaluation table that is inaccurate or vague. The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected. The critical appraisal provides an inaccurate or vague levels of evidence table. The levels of evidence inaccurately or vaguely align to the peer-reviewed articles selected. The critical appraisal provides an inaccurate or vague outcomes synthesis table. The outcomes synthesis inaccurately or vaguely describes the relevance of the peer-reviewed articles and is inaccurately or vaguely aligned to each of the peer-reviewed articles.Poor 0 (0%) – 34 (34%) The critical appraisal provides an evaluation table that is inaccurate and vague or is missing. The critical appraisal provides an inaccurate and vague levels of evidence table or it is missing. The critical appraisal provides an inaccurate and vague outcomes synthesis table or it is missing.Feedback: Part 4B: Evidence-Based Best Practices Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.– Levels of Achievement:Excellent 32 (32%) – 35 (35%) The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed. The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. The responses provide a complete, detailed, and specific synthesis of two outside resources reviewed on the best practice explained. The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided. Accurate, complete, and full APA citations are provided for the research reviewed.Good 28 (28%) – 31 (31%) The responses accurately suggest a best practice that is adequately aligned to the research reviewed. The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained. The response integrates at least one outside resource and two or three course-specific resources that may support the responses provided. Accurate and complete APA citations are provided for the research reviewed.Fair 25 (25%) – 27 (27%) The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed. The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. The responses provide a vague or inaccurate synthesis of outside resources reviewed on the best practice explained. The response minimally integrates resources that may support the responses provided. Inaccurate and incomplete APA citations are provided for the research reviewed.Poor 0 (0%) – 24 (24%) The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing. The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field, or are missing. A vague and inaccurate synthesis of no outside resources reviewed on the best practice explained is provided or is missing. The response fails to integrate any resources to support the responses provided. Inaccurate and incomplete APA citations are provided for the research reviewed or is missing.Feedback: Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.– Levels of Achievement:Excellent 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.Good 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive.Fair 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.Poor 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. No purpose statement, introduction, or conclusion was provided.Feedback: Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.– Levels of Achievement:Excellent 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.Good 4 (4%) – 4 (4%) Contains a few (one or two) grammar, spelling, and punctuation errors.Fair 3.5 (3.5%) – 3.5 (3.5%) Contains several (three or four) grammar, spelling, and punctuation errors.Poor 0 (0%) – 3 (3%) Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Feedback: Written Expression and Formatting—The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.– Levels of Achievement:Excellent 5 (5%) – 5 (5%) Uses correct APA format with no errors.Good 4 (4%) – 4 (4%) Contains a few (one or two) APA format errors.Fair 3.5 (3.5%) – 3.5 (3.5%) Contains several (three or four) APA format errors.Poor 0 (0%) – 3 (3%)

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