Fundamentals Clinical Makeup Assignment

Summer 2021

Student Name:

Assessment

1. Make a list of variables that may impair a nurse’s ability to gather data that are complete, accurate, factual, and relevant.

2. In a brief report, describe the purpose of the four types of nursing assessments (initial assessment, focused assessment, emergency assessment, time-lapsed assessment), and give an example of a case in which each would be conducted.

Diagnosing

3. Explain the following statement: The etiology of the problem directs the nursing intervention.

4. Case Study: A 16-year-old girl delivers her baby at home in her bedroom. Her parents find her and bring her and her baby to the emergency department. The baby is premature and in respiratory distress, and the mother has uncontrolled bleeding. The mother blames the situation on her daughter’s boyfriend, a fellow classmate, who denies any responsibility for the baby.

Make a list of one of the following areas:

(a) patient strengths:

(b) patient problem areas:

(c) potential patient problems:

Outcome Identification and Planning

5. Read the following situation and respond in writing to the accompanying questions:

A client is a 49-year-old homemaker seen in the emergency department to rule out fractures. She states that she lost her balance and fell down her basement stairs. Her husband is constantly at her side, and she appears fearful. You recall previous admissions for lacerations, bruises, and a fracture.

· How would you develop and prioritize the patient’s nursing diagnoses?

· What would be appropriate long- and short-term goals for the priority nursing diagnosis?

· What would be appropriate nursing orders for the priority nursing diagnosis?

Implementing

6. Using the Internet (must be a credible source- include citation and reference list), research a new nursing strategy or practice that has proven effective and write a paragraph about how you could incorporate this into your own nursing practice.

Evaluating

7. Describe how you use your weekly clinical experiences to develop self-awareness of your clinical strengths and weaknesses. What would be your plan for self-improvement? Then, discuss the value of reflection and self-awareness.

8. Discuss the following statement and its implications: We owe it to our patients to be the best nurses we can be.

Case Studies, Urinary Elimination

1. You are a hospital nurse caring for a 62-year-old accountant who was admitted following a motor vehicle accident. During her hospitalization, a significant lack of urination was detected. Her primary care physician has ordered significant testing while the patient is recovering from her injuries.

a. What circumstances could be causing her infrequent urination?

b. How can infrequent urination negatively impact a patient’s health?

c. Outline how urination may be affected by the effects of aging.

d. Describe the effects of decreased bladder and sphincter tone on urination.

e. What can cause decreased urinary structure muscle tone?

2. You are a urologic nurse whose patient has voiced concern over his kidneys losing their function within the past few weeks. He has maintained a log of the past week, recording his urination and fluid intake. He has a history of diabetes mellitus and hypertension, which are treated with medication.

a. In your patient interview, how would you define renal failure for your patient?

b. Which diseases could be included as possible etiologies for renal failure?

c. What data should be included in a complete urinary system assessment?

d. How might an accurate urinary output measurement be obtained?

e. What is important to remember when collecting a 24-hour urine specimen?

Case Studies, Bowel Elimination

3. You are a visiting nurse checking in on your patient, a 93-year-old retired steelworker who lives alone with his two cats. You visit him on a weekly basis to monitor his blood glucose levels and refill his insulin syringes for his self-medicating throughout the week, as he is visually impaired. During your interview, he indicates that he has been experiencing irregularity and is quite anxious over developing a bowel obstruction.

f. How would you assess his bowel elimination patterns?

g. Describe foods that impact bowel elimination either positively or negatively.

h. What activities could you recommend to maintain adequate bowel function?

i. Outline how fiber and fluid intake facilitate bowel elimination.

j. Which mechanical function of the bowel causes constipation?

4. You are a nurse in a medical-surgical hospital unit caring for a patient who had an open cholecystectomy 3 days earlier. Subsequently, the patient developed a paralytic ileus. Additional complications require continued postoperative antibiotic infusions.

a. What nursing assessment finding could indicate the presence of a paralytic ileus?

b. Which medical interventions could have contributed to the development of your patient’s paralytic ileus?

c. How long would you expect the paralytic ileus to last?

d. In what ways would you expect a paralytic ileus to resolve?

e. List possible nursing diagnoses for this patient related to the surgical procedure and postoperative complications.

Case Study: Death and dying- Read and review Chapter 43- (Loss, Grief, & Dying).

Simulation Scenario: Patient is wheezing, Sats drop to 89%, skin is mottled, patient is full code. You will need to apply oxygen and titrate the amount of oxygen up from nasal cannula, to simple face mask, to non-rebreather mask. You will then give an S.B.A.R. report to the provider. You will administer a nebulizer treatment. While the nebulizer is going, your patient’s family has a care conference with palliative care providers and they decide to back off on aggressive cares and move to a comfort care approach. You will need to use what you learned in Chapter 43- Loss, Grief, and dying along with other resources to alter your plan of care for your patient once the family and patient have decided to switch to comfort care.

Review the signs of impending death. Review the likely goals a person will have when changing from acute care to hospice/comfort care or palliative care according to Maslow’s Hierarchy of Needs.

What is the difference between hospice and palliative care? ___________________________________________________________ ______________________________________________________________________________________________________________________

What happens physiologically in each major body system when a person dies? _____________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What are the rights of a dying person?

____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

“It is well within the scope of your professional practice as a competent nurse to provide counseling and death education, especially when the patient asks for it and indicates an unmet need for such information” (Taylor, Lillis & Lynn, 2015, p. 1618).

When should you call in family and notify them of impending death?

What is involved in post-mortem care?

Caring for the body- _______________________________________________________________________________________________________________________________________________________________________________________________

Caring for the family- _____________________________________________________________________________________________________________________________________________________

 

The purpose of this assignment is to create an educational risk management presentation.

Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.

Keep in mind that the PowerPoint is meant to serve as a visual aide to bolster your presentation and is intended to highlight main ideas and key points. Do not use dense blocks of text or more than 7 bullet points of text per slide.  However, you may include supplementary images, graphs, and data where relevant.

To successfully complete this assignment, include the following sections as per your outline from Topic 2, though you may include any additional sections as needed:

1. Introduction
2. Rationale
3. Support
4. Implementation
5. Challenges
6. Evaluation
7. Opportunities

You are required to support your statements with a minimum of six citations from appropriate credible sources.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style. 

Instructions: Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide citations/references for your answers in APA format.

CASE STUDY: Active Labor: Susan Wong 

Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy. 

She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information. 

Reflective Questions 

1.  As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs? 

2.  How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views? 

3.  With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future? 

 Overview

This assignment must be completed on the template provided. This assessment requires you to explore the literature to find 2 research articles that are examples of 2 different levels on the levels of evidence hierarchy. The pyramid that illustrates the levels of hierarchy is on page 13 in your textbook. Please read about the levels of evidence to ensure you understand them before selecting your articles.

Objectives

• Understand the research levels of evidence hierarchy (pyramid)
• Demonstrate effective data base search strategies
• Identify studies by level of evidence

Due Date: Sun, Jun 6 by 11:59 p.m. Eastern Standard Time (EST) of the US.

Point Value: 30

Instructions

To be successful, complete the following steps in order:STEP 1. Review the instructional materials and finish learning activities in module 4STEP 2. Click here to download the rubric. Click here to download the template. 

Required Resources
Read/review the following resources for this activity:

• Textbook: Chapter 4
• Minimum of 3 scholarly sources (in addition to the textbook)

Instructions
As part of the discussion this week, you made a brief exploration of a work of art to understand its subject, meaning, and intent. In this assignment, you will explore an artwork in more depth to consider the context in which it was created. Choose any painting, and address the following:

• Explain the artistic movement associated with the work of art.
• Describe the style of the artist (How is the artist unique within the movement?)
• Examine in some depth the influences that shaped the work. Address at least 2 of the following:
  • Stylistic influences
  • Subject/content influences
  • Cross-disciplinary influences such as literature, philosophy, music, science, technology, etc.
  • Historical influences
  • Political influences

• Reflect on your learning.
  • How did your research enhance your appreciation of the artwork?
  • How does understanding the context of a work help in interpreting it?

Include the following in your paper:

• Name of the painting
• Name of the artist
• Date created
• Image of the painting

Writing Requirements (APA format)

• Length: 1.5-2 pages (not including title page, references page, image, or caption for artwork)
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 3 scholarly sources)