Pneumonia in 12 years old

  

Instructions: Select one of the topic mentioned below and discuses filling the attached form.

Topics: 

Pneumonia in 12 years old

Requirements

Ø The discussion must address the topic

Ø Rationale must be provided

Ø Use at least 600 words (no included 1st page or references in the 600 words)

Ø May use examples from your nursing practice

Ø Formatted and cited in current APA 7

Ø Use 3 academic sources, not older than 5 years. Not Websites are allowed.

Ø Plagiarism is NOT permitted

moral and ethical dialog

It is challenging to engage in meaningful discussions with patients when moral and ethical dilemmas present themselves.

How we engage with our patients can have a profound impact on the care they receive and the decisions they make.

The following exercise will present you with moral and ethical dilemmas common to many clinical practices.  The moral and ethical challenges here are often ones the practitioner will have strong, personal feelings about.

Your task in this exercise is to serve as the practitioner advocate for the patient by engaging in dialog that does not project personal bias or prejudice while also providing the patient with the medical information needed to make an informed, personal decision.  As you choose your responses, try to use one of the ethical decision-making models we’ve explored to systematically evaluate each dilemma and choose the best way to engage the patient in dialog.

https://webapps.srm-app.net/CanvasContent/SF/WCU_NURS_521_DE_TEMPLATE/Case_Study/Conducting%20Moral%20and%20Ethical%20Dialog%20in%20Clinical%20Practice/story_html5.html

The following questions refer to your experience in this week’s exercise, Conducting Moral and Ethical Dialog in Clinical Practice. Describe your overall experience with the moral and ethical dialog exercise, and address at least three (3) of the following:

  • Did you find any of the scenarios more difficult to deal with than others? 
  • Did you feel any internal conflict with any of the scenarios? 
  • How did your personal and professional background impact how you decided to interact with the patient? 
  • Do you feel the responses the patient gave to the practitioner’s response were reasonable or typical? 
  • Were you taken aback by any of the patient reactions? 
  • How might this activity contribute to your role as a nurse advocate in a moral and ethical practice? 
  • Did you utilize an ethical decision making model to explore a systematic way to evaluate any of these ethical dilemmas? If so, describe the effectiveness.  

interview and physical appraisal of the community.

The purpose of this assignment is to conduct a community assessment in a form of an interview and physical appraisal of the community.

DISCUSSION BOARD 5

Describe incidence, prevalence, morbidity, mortality and hospitalizations of COVID-19, compared to the rate of vaccinations in different counties in Maryland. What is your analysis of vaccination rates in the state? 

Please give 3 scientific citation.

Triage

 

Triage involves the rapid assessment and prioritization of patients. Compare the three-tiered system of triage to the Mass Casualty Incident (MCI) triage philosophy. Imagine that you are the Triage Nurse during an MCI. How will you categorize the following patients using the MCI triage philosophy? Explain your answer. Are there any ethical issues that should be considered?

  • 10-year-old boy with massive head injury, no spontaneous breathing, BP 60 palp
  • 22-year-old female with a close fracture of the left arm
  • 60-year-old male with a laceration in the leg complaining of shortness of breath
  • 15-year-old girl with glass embedded in the eyes
  • 52-year-old male with a pulse of 30 and a blood pressure of 70/30

NURSING







Student Instructions for Standardized Simulation

NR325 Mary Lou and Rob Brady Scenario 1 (NLN)

PURPOSE:

The following information is to be used in guiding your preparation and participation in the scenario for this course. This document will provide applicable course outcomes in preparation for your simulation.

SCENARIO OVERVIEW:

Mary Lou Brady is a 20-year-old patient who had a right-sided stroke eight days ago. She was in the hospital for four days and is now in an acute care rehabilitation center, where she is having some difficulty acclimating to her new life and body changes.

Mary Lou is a patient in the medical surgical/rehabilitation center. She is eight days post-stroke and participates in rehabilitation for three hours every morning and afternoon. Her husband and family have been an excellent support system for her, but she is struggling with the demands of her rehabilitation.

STUDENT ROLES DURING SIMULATION:

During pre-briefing, you will be assigned one of these roles according to the description below to participate in the simulation as a nurse. After completing your assessment, you are expected to document your findings as a nurses note in SBAR format.

Charge Nurse:

The charge nurse is responsible for the overall organization of safe, quality patient care. You are the team leader and serve as a resource to all interdisciplinary members and are responsible for appropriate delegation of duties. You will serve as the point person for communication and can anticipate speaking with the physician or other primary care provider, ancillary support services, and others directly involved with the care being provided. You must be knowledgeable about the patient’s condition and able to dictate orders obtained and assist with implementation if needed. Additionally, be prepared to prioritize care and anticipate future needs.

Documentation Nurse:

The documentation nurse is responsible for recording of all patient event activities during the simulation with the exception of medication administration. You are responsible for documenting assessments, interventions, and outcomes on the designated tool (paper or electronic). Be prepared to read back and verify your documentation when requested and/or clarifying the details. Additionally, you will be part of the interdisciplinary team and will contribute observational assessment findings to include but not limited to changes in vital signs, alerts, psychosocial needs, and anticipated care.

Assessment Nurse:

The assessment nurse is responsible for overseeing a comprehensive assessment of the patient. This includes but is not limited to obtaining vital signs, head-to-toe assessment of all systems, and psych/social assessment of the patient. You will be prioritizing care, executing independent interventions, collaborating with interdisciplinary team members, anticipating the needs of the patient/family, and re-assessing or continually monitoring the patient for any changes in condition. You are responsible for implementing all non-medication-related interventions, verbalizing your findings to the team, and recommending any actions/interventions required. Additionally, you will be providing appropriate education to the patient and family/significant others.

Medication Nurse:

The medication nurse is responsible for all actions and documentation related to safe administration of medications. You will identify and correct any medication errors related to prescribing or distribution. This may include speaking with the physician or primary care provider. Prior to administering medication, you will assure the “Rights of Medication Administration”. You must be knowledgeable regarding the action and expected effects of the medications being administered and are responsible for monitoring and reporting any adverse reactions or unforeseen consequences of administration. Part of your role includes verifying medication calculations with a colleague and identifying any incompatible drug combinations.

Observer Nurse:

The observer is a non-participant role and will not communicate directly with the simulation team. The observer nurse will view the simulation in the briefing room through Learning Space as it is occurring. There may be multiple observer nurses in each scenario. The observer nurse will be given an observation guide to complete during the simulation. The data you collect will help the team during the debriefing process and facilitate an open and active discussion regarding the simulation experience. You will be an active participant in the debriefing and will be encouraged to share your observations and thoughts. Please keep in mind that your observations should be conveyed in a respectful, educational manner. The goal is to work together as colleagues in providing safe and effective care.

CONFIDENTIALITY:

To preserve the educational value, integrity and safety of the learning environment, you agree to maintain strict confidentiality about the proceedings of the simulation session, details of the training scenarios and the performance of all participants. You acknowledge that this expectation aligns with the guidelines related to the Health Insurance Portability and Accountability Act (HIPAA) as well as laws governing Protected Health Information (PHI) in client care environments.  

You will not view, discuss, share, record or disclose any confidential information pertaining to the session. You understand that lapses in confidentiality are considered academic misconduct and could result in dismissal from the academic program. 

 

FICTION AGREEMENT:

You will suspend judgment of realism for any given simulation in exchange for the promise of learning new knowledge and skills, treating the simulated patients with the same care due an actual patient, act with a genuine desire to learn even when it may be difficult to do so.  

LEARNER OBJECTIVES:

1. Complete a neurological assessment of a patient who has had a stroke. ​

2. Complete a psychosocial assessment of a patient who has had a stroke. ​

3. Provide appropriate nursing interventions for a post-stroke patient who is experiencing grief and loss related to having a stroke. ​

4. Use appropriate communication techniques during interactions with a post-stroke patient who is experiencing grief and loss and is attempting to cope with changes in body image. ​

5. Recognize the implications of the patient’s existing disability on the patient’s current and future healthcare needs.

COURSE OUTCOMES:

The NR325/NR330 standardized simulation enables the student to meet the following priority course outcomes:

CO 1: Provide effective professional nursing care for adult patients and their families in acute care settings using the nursing process. (PO 1)

CO 4: Apply critical thinking strategies to make good clinical decisions in the adult patient clinical setting. (PO 4)

CO 6: Relate knowledge and principles of legal, ethical, and professional standards to clinical practice in the acute care setting, with adult patients and their families. (PO 6)


**Although this scenario can address multiple course outcomes, faculty and students should focus on the course outcomes listed above**

DUE DATE:

The standardized simulation will be conducted during


Week 5

to ensure students are prepared to meet the objectives.

SIMULATION TIMING:

· Pre-brief: 20 minutes

· Prebrief Skills Review (OPTIONAL): 30 minutes

· Run Time: 30 minutes

· Debrief: 60 minutes

REVIEW AND COMPLETE BEFORE THE START OF PRE-BRIEFING:

In order to prepare for the simulation, you should complete your assigned reading for the course. In addition, you should be prepared to complete and document a thorough nursing assessment along with completing the following skills:

·

Neurological Assessment

·

Therapeutic Communication

·

Grief and Loss

·

Utilizing I-SBAR for reporting

Please keep in mind you will also be required to recognize a variety of signs and symptoms linked to abnormalities in these skills.

Therefore, in order to prepare for the simulation, you are
required to complete the pre-briefing questions below and submit them to the faculty facilitating the simulation before the start of pre-briefing. If you do not complete the pre-briefing questions below and submit to the faculty facilitating the simulation before the start of pre-briefing, you will
not be permitted to participate in the simulation.

Use textbook and other resources to answer questions:

1. What are some causes of strokes in younger women?

2. What do you need to focus on when completing a neurological assessment for someone who just experienced a stroke?

3. What do you educate the patients about the signs and symptoms of a Stroke and when to call 911?



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Response

  

Respond using APA, at least 2 scholarly references

Leadership Insights

Research indicates that promoting leadership development among employees requires the existence of effective organizational leadership (Mabona et al., 2022). This provided insight as the building up of our nursing leadership has been stagnant due to unease with executive leadership. Strong, effective leadership, or lack of, directly influences care, quality and motivation of staff (Mansel & Einion, 2019). We have nurses and leaders with great approaches for change, but a lack of motivation to do so. What was lacking was effective communication strategies, the ability for nurses to be actively involved in making decisions regarding patient care and having a substantial level of professional independence and influence over our work environment (Mabona et al., 2022).

During this week’s reading and research I stumbled across transformational leadership being an evidence-based leadership theory for nursing practice. It makes sense as building a trusting and respectful relationship is essential for implementing and fostering an empowering work environment. An empowering work setting is marked by the provision of information, support, resources, and learning opportunities (Mabona et al., 2022). Creating a supportive work environment fosters a culture of shared knowledge and a higher sense of duty and liability among nurses, while simultaneously safeguarding against and alleviating nurse burnout (Iqbal et al., 2019). Leaders who strive to cultivate a positive work environment through transformational leadership value and consider various viewpoints, display a comprehensive understanding of concerns, recognize and encourage the valuable contributions of nurses, effectively communicate achievements to boost confidence, maintain an approachable demeanor, and provide assistance to their staff (Mabona et al., 2022).

Transformational Leadership in Practice

We recently hired a new Chief Executive Officer (CEO), a position that has historically been filled by personnel with a clinical or medical background. This CEO however does not have this background. Rather than that hindering his abilities as a leader, he inspirationally utilized that as a key tool in motivating staff. Upon our first interaction, he encouraged the nursing team to take ownership of our profession/department and provide him with justifications to our needs and goals. He was transparent in pointing out that he is naïve to what we do and what our needs are, yet was able to still support us a valuable partners in the organization and pledge support to our success as well. This defined him as a transformational leader.

Interestingly enough, study findings show that when nursing staff perceives their leader as transformational, their psychological empowerment is enhanced, and they have higher well-being, which in turn increases their commitment to their workplace (Iqbal et al., 2019). This deemed true for our organization. The CEO sparked motivation that was lacking previously and motivated the nursing team to implement changes that were long overdue. Our admissions process was tedious and outdated for quite some time and was needing revamped but had previously lacked the support to do so. We then did a time study on the process for two-weeks, reviewed the ways in which we could improve that process, piloted those changes, completed a time study to evaluate the effectiveness of those changes, and then received the approval to move forward with those changes. A transformational leadership model has had a positive impact on our department and facility as a whole. Employee attitudes and behaviors have changed which has in turn increased job performance, satisfaction, and turnover.

References

Iqbal, K., Fatima, T., & Naveed, M. (2019). The impact of Transformational leadership on nurses’ organizational Commitment: a multiple mediation model. European Journal of Investigation in Health, Psychology and Education, 10(1), 262–275. https://doi.org/10.3390/ejihpe10010021

Mabona, J. F. M., Van Rooyen, D., & Ham-Baloyi, W. T. (2022). Best practice recommendations for healthy work environments for nurses: An integrative literature review. Health Sa Gesondheid- Journal of Interdisciplinary Health Sciences, 27. https://doi.org/10.4102/hsag.v27i0.1788

Mansel, B., & Einion, A. (2019). ‘It’s the relationship you develop with them’: emotional intelligence in nurse leadership. A qualitative study. British Journal of Nursing, 28(21), 1400–1408. https://doi.org/10.12968/bjon.2019.28.21.1400

Discussion

 Middle-Range Theories  

SHORT ANSWER

Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

  1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
  2. List 4 predictors of late onset generalized anxiety disorder.
  3. List 4 potential neurobiology causes of psychotic major depression.
  4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
  5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.