As a new nurse you are assigned to work with a preceptor in the Emergency Department. It is a very busy day and it seems as if every patient, regardless of chief complaint, has an issue with fluid, electrolyte, and/or acid-base balance. The first patient you see is a 37-year-old landscaper who is brought to the ED after collapsing on a job at the local country club. He is slightly confused but is able to tell you he feels dizzy and weak. His skin is flushed, dry, and with poor turgor. He has dry, sticky mucous membranes. The nurse identifies a nursing diagnosis of deficient fluid volume.

1. Describe how each of the following would change and the rationale for the change in the presence of

   deficient fluid volume:

• Heart rate

• Blood pressure

• Serum hematocrit

• Urinary output

• Urine specific gravity

• Weight

2. What is usually the first indicator that an individual needs more fluids?

3. The ED physician orders IV fluids for this patient. What types of fluids are indicated for a fluid     volume deficit due to dehydration?

4. The fluid order is to start 1000 mL of fluid as ordered at 150 mL/hr. The infusion tubing has a drop factor of 15 gtt/mL. This infusion will run by gravity rather than an infusion pump. How many drops per minute should you time the infusion at to ensure the correct hourly rate?

5. The patient has a “full sleeve” tattoo on both arms. Discuss the implications of this finding and how you will initiate the intravenous site.

6. You have difficulty finding a vein in the presence of the deficient fluid volume.  List 3 strategies that you can use to help make a vein more visible/palpable?

7. Considering the diagnosis, patient presentation, and fluid orders, what size catheter is indicated in this situation? Give a rationale for your choice.

8. After 30 minutes of the infusion, the patient states, “My arm where the needle is feels funny.” What should you do first? What further data do you need from the patient?

Several hours later the patient is feeling better and is now oriented × 3. The ED physician wants the patient to be drinking oral fluids without difficulty prior to being discharged from the ED.

9. List 3 strategies to increase fluid intake that are most appropriate to this setting.

10. The patient is discharged after adequate hydration. Discharge teaching includes ways to prevent this from happening again on the job. What key points should the nurse include in the teaching applicable to the job site?

 

Professional Capstone and Practicum Reflective Journal

Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. Health disparities

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

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 not required to submit this assignment to LopesWrite.

3) Mr. B is a 70 year old man who developed sub sternal chest pains radiating down his left arm while at home. he was taken to the ER via ambulance. His breathing was labored, pulses rapid and weak and his skin was cold and clammy. an ECG was done which revealed significant “Q” waves in most leads. Troponin level was elevated. Arterial blood was draw with the following results.

Ph 7.22

PCO2 30 MM

HG PO2 70 MM

HG O2 SAT 88%

HCO3 22 MEQ/LITER

1. Aside from the obvious diagnosis of MI, what is Mr. B’s acid base status and what caused this disturbance?

post your initial response by Tuesday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references  are required (other than text). Refer to grading rubric for online discussion.

Due May 31 by 11:59pm

• Required Resources
  Read/review the following resources for this activity:
• Textbook: Chapter 9, 10
• Minimum of 1 scholarly source (in addition to the textbook)

Instructions
This week you will use your readings from the past week as a point of departure to create your own artistic production and a reflection paper.

Part 1: Art Creation
Select a poem, musical piece, or dance piece to use as a point of inspiration. Create a work of poetry, lyrics, music, or dance, inspired by your selected art piece. Video or audio recordings should be no longer than 5 minutes and must be in MP4 format.

Note: If your art creation requires a separate file submission, please submit in the Art Creation Submission (Recordings) area following this assignment.

Part 2: Reflection
Write a reflection about the relationship between your art production and the inspiration piece. Include the following in the reflection paper:

• Introduction
• Inspiration Piece
  • Include the inspiration poem, lyrics, or recording of musical or dance piece within the document. Use a link in the case of a recording.
  • Record the title, artist/author/composer, year, and place of origin.
  • Briefly explain the background of the inspiration piece.
• Your Art Piece
  • Include your original poem or lyrics within the document. If you selected a musical or dance piece, submit as a separate file in the Art Creation Submission (Recordings) area following this assignment.
  • Provide a title.
  • Explain the background of your piece.
• Connection
  • Explain the thematic connection between the two pieces.
  • How are they similar and different?
  • Are they the same medium? How does the medium impact what the viewer experiences?

Original Artwork Requirements

• Methods: typed poem or lyrics, or recording of musical or dance piece
• No computer-generated pieces

Writing Requirements (APA format)

• Length: 1.5-2 pages (not including title page, text of inspiration piece, or references page)
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 1 scholarly source)

PLEASE FOLLOW THE INSTRUCTIONS BELOW

4 REFERENCE

ZERO PLAGIARISM

Nice attempt but you did not address the following questions:
-Explain pharmacological and nonpharmacological treatments for children and adolescents with the diagnosis. (30 points)
-Explain appropriate community resources (25 points)

Re-submission not allowed at this time for this assignment. 

 TOPIC: Major Depressive Disorder 

Patient education is an effective tool in supporting compliance and treatment for a diagnosis. It is important to consider effective ways to educate patients and their families about a diagnosis—such as coaching, brochures, or videos—and to recognize that the efficacy of any materials may differ based on the needs and learning preferences of a particular patient. Because patients or their families may be overwhelmed with a new diagnosis, it is important that materials provided by the practitioner clearly outline the information that patients need to know.

For this Assignment, you will pretend that you are a contributing writer to a health blog. You are tasked with explaining important information about an assigned mental health disorder in language appropriate for child/adolescent patients and/or their caregivers. 

To Prepare

• By Day 1, your Instructor will assign a mood or anxiety disorder diagnosis for you to use for this Assignment.
• Research signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals.

The Assignment

In a 300- to 500-word blog post written for a patient and/or caregiver audience, explain signs and symptoms for your diagnosis, pharmacological treatments, nonpharmacological treatments, and appropriate community resources and referrals.
Although you are not required to respond to colleagues, collegial discussion is welcome.