Competency

Compare strategies for safe, effective multidimensional nursing practice when providing care for clients with lower respiratory disorders.

Scenario

You are a nurse on a pulmonary rehabilitation team at an outpatient clinic in your community. You are updating educational resources to educate clients who want to know more about health promotion and maintenance and improving pulmonary health related to their lung conditions. 

Instructions

Create an infographic for a lower respiratory system disorder that includes the following components:

• Risk factors associated with the common lower respiratory system disorder.
• Description of three priority treatments for the lower respiratory disorder.
• Description of inter professional collaborative care team members and their roles to improve health outcomes for the lower respiratory system disorder.
• Description of three multidimensional nursing care strategies that support health promotion and maintenance for clients with the lower respiratory system disorder.
• Description of a national organization as a support resource for your client specific to the lower respiratory system disorder.

Discussion 1:

Margaret is a 40-year-old white female in for her annual asses. She states she has been under increased stress in her life for the past few months. She and her husband are currently separated and considering divorce. Her teenaged sons are acting out and she is working extra hours to make ends meet. Secondary to the increased stress she has started smoking again, “about a pack per day” and states “I know that I am not eating right.”
Margaret has been on the “pill” for almost 20 years and has always liked the method. She states the she has heard that smoking and taking the pill are not good, and she is worried about that. “I really do not need birth control since I am separated but just in case I probably need something.” She states that she has been in a mutually monogamous relationship (as far as she knows) since her marriage 18 years ago. She denies a new partner since her separation. Menarche was at 11 years, her cycles when on the pill are regular and very light. Her menstrual period should start tomorrow as she just finished her active pills. She denies a personal history of abnormal Pap smears, gynecological issues, hypertension (HTN), or diabetes. She is G2P2002, and her pregnancies were full term and uncomplicated at ages 24 and 26. Family history is significant for both parents with HTN and mom has type 2 diabetes. Her paternal grandfather died at age 64 years from type 2 diabetes, HTN, and coronary artery disease. Her other grandparents died in their late 70s early 80s and she is unaware of any medical issues.

Assessment:

Margaret’s assessment finds her height 5’5″, weight 172 lb (up 10 lb. from last year), current body mass index (BMI 28.6), and blood pressure (BP) 148/88. Head, eyes, ears, nose, and throat (HEENT) are grossly within normal limits (WNL). No thyromegaly or lymphadenopathy. Heart rate is regular and rhythm is without murmurs, thrills, or rubs. Lungs are clear to auscultation in all lobes. Breasts are without masses, nipple discharge, asymmetry, or lymphadenopathy; self breast examnation techniques and frequency reviewed during examnation. Abdomen is soft, nontender, with no masses or hepatosplenomegaly; bowel sounds present in all four quadrants. Pelvic assessment reveals normal vulva and negative Bartholin’s and Skene’s glands; vagina is pink, rugated, with minimal white nonodorous discharge; cervix is pink, multiparous os. Pap smear collected during speculum examination was normal. Bimanual examination reveals a retoverted, firm, mobile, nonenlarged, nontender uterus with negative cervical motion tenderness; adnexa nontender; and ovaries palpable bilaterally, mobile, without masses. Lower extremities were without edema or varicosities.

1. What options are appropriate for this patient?
2. What contraceptive options are contraindicated?
3. What type of patient education is indicated?
4. Given that she has a normal pelvic exa, does that change would that influence your decision?

 You must access the following article to answer the questions:

Boyle, D. K., & Thompson, S.A. (2020). CMSRNs’ continuing competence methods and perceived value of certification: A descriptive study. MEDSURG Nursing, 29(4), 229-254. https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=145282314&site=eds-live&scope=site (Links to an external site.)

1. Locate the literature review section. Summarize using your own words from one of the study/literature findings. Be sure to identify which study you are summarizing.
2. Discuss how the author’s review of literature (studies) supported the research purpose/problem. Share something that was interesting to you as you read through the literature review section.
3. Describe one strategy that you learned that would help you create a strong literature review/search for evidence. Share your thoughts on the importance of a thorough review of the literature.

 Go to Congress.gov website and consider the role of RNs and APRNs in policy-making. Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process. Explain  at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples. Atleast 3 APA references

A 4-year-old who requires a life saving organ transplant has been admitted to the local children’s hospital via ambulance. The child was at school, when a school nurse noticed that the child needed immediate medical attention and called 911. The child is joined in the hospital by mom and dad who don’t believe in modern medicine. Because of their views, the parents have not brought the child in for preventive well-child visits. The condition was only discovered when the child became severely symptomatic and required hospitalization. Although organ transplantation is the only chance for long-term survival of the child, mom and dad decide to not place their child on the transplant list.

As the child’s nurse, should you respect the parents decision to decline life saving measures, or should you report the case to children services for potential neglect and further investigation?

Below is the article you will be using for the powerpoint presentation slides 

https://pediatrics.aappublications.org/content/143/1/e20181551 

and add any reference you want to use.

Statistical Significance and Ethical Principles this is the two I want on the powerpoint presentation slide