Evidence-Based Population Health Improvement Plan

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For this assessment, you will create a 5-7 slide PowerPoint presentation about a population health improvement plan. You will then record a video of no more than five minutes presenting your PowerPoint.

Introduction

Master’s-level nurses need to be able to think critically about the evidence, outcomes data, and other relevant information they encounter throughout their daily practice. Often the evidence or information that a nurse encounters, researches, or studies is not presented in the exact context of that nurse’s practice. A key skill of the master’s-level nurse is to transfer evidence from the context in which it was presented and apply it to a different context in order to maximize the benefit to patients in that new context.

Professional Context

Master’s-level nurses need to be able to think beyond the bedside. It is important to be able to research, synthesize, and apply evidence that will result in improved health outcomes for the communities and populations that are part of your care setting. Improving outcomes at a community or population level, even incrementally, can create noticeably significant, aggregate health improvements for patients across all of a care setting.

Scenario

Your organization has created an initiative to improve one of the pervasive and chronic health concerns in the community. Some examples of possibilities for health improvement initiatives include type 2 diabetes, HIV, obesity, and communicable diseases. You will need to do your own research to gather and evaluate the relevant data for your chosen issue.

Once you have created a presentation for the initiative, you have been asked to present to a group of community stakeholders. The purpose of your presentation is to inform and enlist support for the initiative from your audience.

Instructions

The optional Evidence-Based Population Health Improvement Plan Presentation Template [PPTX] is provided to help you prepare your slides. If you choose to work without the template, consider referring to Creating a Presentation: A Guide to Writing and Speaking and Guidelines for Effective PowerPoint Presentations.

The suggested headings for your presentation are:

  • Community Data Evaluation.
  • Meeting Community Needs.
  • Measuring Outcomes.
  • Communication Plan.
  • Evidence.

In your presentation, you will:

  • Evaluate the environmental and epidemiological data about your community to determine a population-focused priority for care.
    • Identify the relevant data. This can be communicated in a table or chart. 
    • Describe the major population health issue suggested by the data within your community.
    • Explain how environmental factors affect the health of community residents.
    • Identify the level of evidence, validity, and reliability for each source.
    • Explain what evidence in the current literature (within the last 5 years) supports your evaluation of the data and the population focused priority of care you have selected.
  • Develop an ethical health improvement plan with outcome criteria that addresses the population health priority that you identified in your evaluation.
    • Consider the environmental realities and challenges existing in the community.
    • Include interventions that will meet community needs.
    • Address potential barriers or misunderstandings related to various cultures prevalent in the community.
    • Propose criteria that can be used to evaluate the achievement of the plan’s outcomes for your population health improvement.
      • Explain why your proposed criteria are appropriate and useful measures of success.
  • Explain a plan to collaborate with a specific community organization to support the implementation of the population health improvement in an ethical, culturally sensitive, and inclusive way.
    • Identify the community stakeholders that are relevant to your Population Health Improvement Plan.
    • Develop a clear communication strategy that is mindful of the cultural and ethical expectations of colleagues and community members regarding data privacy.
    • Ensure that your strategy enables you to make complex medical terms and concepts understandable to members of the community regardless of disabilities, language, or level of education.
  • Explain the value and relevance of the evidence and technology resources used as the basis of a population health improvement plan.
    • Explain why the evidence is valuable and relevant to the community health concern you are addressing.
    • Explain why each piece of evidence is appropriate and informs the goal of improving the health of the community.
  • Communicate the Evidence-Based Population Health Improvement Plan in a professional, effective manner that engages the community organization stakeholders and the community-at-large to implement and sustain change.
    • What specific actions can the community stakeholders take themselves to build a feeling of community ownership in your plan?
  • Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.

Submission Requirements

  • Length of submission: 5–7 slides. Balance text with visuals. Avoid text-heavy slides. Use speaker’s notes for additional content.
  • Length of Video Presentation: No more than five minutes.
  • Font and font size: Appropriate size and weight for a presentation, generally 24–28 points for headings; no smaller than 18 points for bullet-point text. Use a suitable professional typeface, such as Times or Arial, throughout the presentation.
  • Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your evaluation, recommendations, and plans. Current source material is defined as no older than five years unless it is a seminal work.
  • APA formatting: Resources and citations are formatted according to current APA style.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 1: Apply evidence-based practice to plan patient-centered care.
    • Explain a plan to collaborate with a specific community organization to support the implementation of the population health improvement in an ethical, culturally sensitive, and inclusive way.
  • Competency 2: Apply evidence-based practice to design interventions to improve population health.
    • Develop an ethical health improvement plan with outcome criteria that addresses the population health priority for care identified in the evaluation.
  • Competency 3: Evaluate the value, relevance, and ethics of available evidence upon which clinical decisions are made.
    • Evaluate the environmental and epidemiological data about your community to determine a population-focused priority for care.
    • Explain the value and relevance of the evidence and technology resources used as the basis of a population health improvement plan
  • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
    • Communicates the Evidence-Based Population Health Improvement Plan in a professional, effective manner that engages the community organization stakeholders and the community-at-large to implement and sustain change.
    • Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

informed consent

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Choose a patient-care situation in which the RN should intervene and advocate for the patient.  An example of such a situation might be when a patient has not been given complete informed consent.

  • Describe the clinical situation concisely and descriptively. It can be an actual situation or a hypothetical one.
  • Apply the Bioethical Decision Making Model to the specific clinical ethical situation that you choose. Address each section of the model. Conclude with a discussion of nursing advocacy in the clinical setting and the nurse’s role as a patient advocate.  

You must reference and cite 1-2 scholarly sources other than your text. Include a title page and a reference page to cite your text and adhere to APA formatting.

Topic: (End of Life: Physician Assisted Suicide)

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1) Discuss the technical aspects of your topic in general terms.

2) Discuss the public policy debates relevant to the topic you choose. This section should cover arguments that favor and oppose the use of the techniques or products.

3) Express your personal opinion regarding the topic’s importance and the validity of the pro and con arguments. Within the personal opinion/conclusion, frame your position with an ethical theory from the six workable theories (Kant, Act Utilitarianism; Rule Utilitarianism; Care Ethics; Virtue Ethics; and Social Contract).

 

Pharm: Bipolar Type II with Diabetes Type 1

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ASSESSING AND TREATING PATIENTS WITH BIPOLAR II DISORDER AND DIABETES TYPE 1.

For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder.

For this assignment, you will write a 5–6-page paper on the topic of bipolar and bipolar and related disorders. You will create this guide as an assignment; therefore, a title page, introduction, conclusion, and reference page are required. You must include a minimum of 3 scholarly supporting resources outside of your course provided resources.

In your paper, you will choose one of the following diagnoses: Bipolar I, Bipolar II, Cyclothymic Disorder, Substance/Medication-Induced Bipolar and Related Disorder, Bipolar and Related Disorder Due to Another Medical Condition. Your paper will include discussion for your chosen diagnosis of bipolar and related disorder on the following:

· Prevalence and Neurobiology of your chosen disorder ( Bipolar II and Type 1 Diabetes)

· Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria

· Discuss special populations and considerations (children, adolescents, pregnancy/post-partum, older adult, emergency care) for your chosen bipolar and related disorder; demonstrating critical thinking beyond basics of HIPPA and informed consent with discussion of at least one for EACH category:  legal considerations, ethical considerations, cultural considerations, social determinants of health

· Discuss FDA and/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder

· Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings.  What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.
(use Escitalopram for Bipolar II and Insulin for Diabetes Type 1)

 

References:

Stahl, S. M. (2021). 
Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.

· Chapter 7, “Treatments for Mood Disorders: So-Called “Antidepressants” and “Mood Stabilizers” (pp. 338-358)

American Psychiatric Association. (2010b). 


Practice guideline for the treatment of patients with bipolar disorderLinks to an external site.


 (2nd ed.)
. 
https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf.

Hirschfeld, R. M. A. (n.d.). 


Guideline watch: Practice guideline for the treatment of patients with bipolar disorder

Links to an external site.
 (2nd ed.)
.  https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-watch.pdf

Nursing Homework

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Aron Ralston, an avid outdoorsman, was hiking in a narrow canyon in Southern Utah when he upset a large boulder that rolled down the canyon after him. As it fell, the boulder relodged itself between the narrow canyon walls and in the process pinned Aron’s right wrist between the boulder and the canyon wall. Aron was alone and was unable to free himself from the situation. After being trapped for five days, with no help arriving, Aron eventually made the decision to free himself by breaking the bones in his forearm with the weight of his body and amputating his hand with a dull pocketknife. After freeing himself, he hiked an additional seven miles before the search and rescue crews found him. His arm required further surgery to repair it. After the surgery, the nurses would ask Aron, “On a scale of 0-10, what is your pain level with 0 being no pain and 10 being the most pain you have ever experienced?”. Aron would reply, “0.25”. When asked about giving such an odd answer, he stated that even though he was in pain after the surgery, it was minimal compared to the pain he experienced when he cut through his ulnar nerve to free himself from being trapped by the boulder.

1. As you reflect on this story, how does it help you understand that pain is a subjective experience for your client? What types of questions will you ask your client to adequately assess their pain level?

2. Why is it important to understand that not all clients experience pain the same?

3. What objective data may be noted when a client is in pain?

4. How might pain be manifested in vital sign measurements?

5. What effects might chronic pain have on the general health of a client?

Pn2

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Pn2

Question 1

A nurse working with clients with sickle cell disease (SCD) teaches about self-management to
prevent exacerbation and sickle cell crises. A client communicates the need for additional
teaching by which of the following statements.

A) “I will avoid extreme stress.”
B) “I will avoid exercise.”
C) “I will drink adequate fluid to avoid dehydration.”
D) I will avoid high altitudes.”

Question 2

A client experiencing a severe asthma attack has the following arterial blood gas results: Ph
7.33; PCO2 48 mm Hg: HCO3 26 mEq/L. Which order should the nurse implement first?

A) Sputum culture
B) Ipratropium inhaler
C) Albuterol nebulizer
D) Chest x-ray

Question 3

A client receiving a heparin infusion demonstrates signs of acute bleeding. Which of the
following should the nurse anticipate the provider to prescribe for to his client?

A) Aspirin
B) Protamine Sulfate
C) Naloxone
D) Vitamin K

Question 4

A nurse is completing the admission assessment of a client who has suspected Pulmonary
edema. Which of the following clinical infestations are expected? (select all that apply.)

A) Thick, yellow sputum
B) Tachypnea
C) Orthopnea
D) Increased urinary output
E) Persistent cough

Question 5

A client is diagnosed with acute peripheral arterial occlusion. The nurse should prepare to
provide which of the following interventions for this client?

A) Apply sequential compression devices (SCDS)
B) Place on a fluid restriction
C) Assist with ambulation
D) Administer heparin as prescribed

Question 6

The post-anesthesia care nurse is caring for a client who just has an aortic valve replacement
surgery. The client’s arterial gases are pH 72..; HCRO3 21 mEQ/L; PCO2 65 mm Hg; and PO2
58 mm Hg. Which is the priority action by the nurse?

A) Increasing the client’s oxygen flow rate
B) Auscultating lung sounds
C) Notifying the provider
D) Documenting the findings

Question 7

A client is receiving spironolactone to treat bilateral lower extremity edema. The nurse should
instruct the client to make which nutritional modification to prevent electrolyte imbalance?

A) Increase intake of milk and milk products
B) Restrict fluid intake to 1,000 ml/day
C) Do not use a salt substitute
D) Increase foods high in sodium

Question 8

A client has a history of heart failure and has been prescribed, digoxin, and potassium chloride.
The client has nausea, blurred vision, headache, and weakness. The nurse notes that the client
is confused, refusing to eat, and complaining of nausea. The nurse should assess the client for
signs of:

A) Pulmonary edema
B) Fluid deficit
C) Hyperkalemia
D) Digoxin toxicity

Question 9

Which action by a client with asthma indicates a good understanding of the nurse’s teaching
about peak flow meter use?

A) The client uses the albuterol metered -dose inhaler for peak flows in the yellow zone
B) The client calls the healthcare provider when the peak flows is in the green zone
C) The client records an average of five peak flow reading every day
D) The client inhales rapidly through the peak flow meter mouthpiece

QUestion 10

A nurse assesses a client in preparation for receiving a blood transfusion. Pre transfusing vitals
are temperature at 98.2 F, heart rate 82 beats/minute, respirations 18 breaths/minute, blood
pressure 1027 mm Hg, and oxygen saturation 96% on room air, fifteen minutes after starting the
transfusion, the nurse measures the following vital signs. Which of the following is the highest
priority of action?

A) Heart rate 112 beats/minute
B) Oxygen saturation 94% on room air
C) Temperature 98.6 F
D) Blood pressure 108/78 mm Hg

Question 11

A client is admitted with an abdominal aortic aneurysm (AAA). For which of the following
complications should the nurse be most concerned?

A) Loss of bowel sounds
B) Cardiac arrhythmias
C) Hypotension
D) ANeurysm rupture

Question 12

Which of the following statements should the nurse teach a client receiving heparin infusion?

A) Vitamin K is used to reverse the effects of heparin
B) International normalized ratio (INR) is use to assess its effectiveness
C) Heparin with facilitate clotting of the blood
D) Partial thromboplastin time value determine the dosage of heparin

Question 13

The nurse is caring for a group of clients on a pulmonary unit. The nurse can delegate which
task to unlicensed assistive personnel (UAP)?

A) Providing oral care
B) Monitoring client response to ambulation
C) Asserting pain level
D) Teaching the client how to use the incentive spirometer

Question 14

Isoniazid and rifampin have been prescribed for a client with tuberculosis. A nurse reviews the
medical record of the client. Which of the following notes would require the nurse to question the
order for these medications?

A) History of kidney stones
B) Triglyceride level of 142
C) Allergy of penicillin
D) Elevated AST and ALT levels

Question 15

Which of the following conditions is most commonly responsible for left heart failure?

A) Murmur
B) Tricuspid valve regurgitation
C) Hypertension
D) Pulmonary valve stenosis

Question 16

Which laboratory test will be most useful to the nurse in determining whether a client admitted
with acute shortness of breath has heart failure?

A) B-type natriuretic peptide (BNP)
B) Cholesterol
C) Serum creatine kinase (CK)
D) Arterial blood gases (ABGs)

Question 17

Which finding requires immediate intervention when planning care for an adolescent with cystic
fibrosis (CF)?

A) Chest pain with dyspnea
B) Delayed puberty
C) Poor weight gain

D) Large foul-smelling bulky stools

Question 18

A young adult is admitted to the emergency department after an automobile accident. The client
has severe pain in the right chest from contract with the steering wheel. What should the nurse
do first?

A) Perform a focused respiratory assessment
B) Reduce the client’s anxiety
C) Maintain adequate circulating volume
D) Administer pain medication

Question 19

A client who underwent a lobectomy and has a water seal chest drainage system appears to
have an increased work of breathing and a faster respiratory rate than 1 hour ago. The client’s
pulse rate is also increased. The nurse should do which of the following?

A) Check the tubing to ensure that the client is not lying on it or kinking it
B) Ensure that the chest tube has two clamps on it to prevent air leaks
C) Lower the drainage system 2 or 3 feet below the level on the client’s chest
D) Increase the section q

Question 20

The nurse is preparing a teaching plan for a client who is being discharged after being admitted
for atherosclerosis. The client has been taking simvastatin 40 mg for the last two years. The lab
results for the clients lipid panel result are total cholesterol 195 mg/dl; triglycerides 106 mg/dl;
and high-density lipoprotein (HDL) 69 mg/dl. Which action should the nurse take?

A) Tell the client that the cholesterol level are within normal limits
B) Review the chart for lab reports of hemoglobin and hematocrit
C) Instruct the client to lower the saturated fat in their diet
D) Ask if the client is taking the simvastatin regularly

Question 21

A client is experiencing an acute asthmatic attack. The client is noted to have respirations of 40
oxygen saturation 86% on room air, and lungs sounds with audible wheezing. Which arterial
blood response to treatment with albuterol?

A) pH: 7.27, CO2: 41 mm Hg, HCO3: 14 mm Hg
B) pH: 7.6, CO2: 34 mm Hg, HCO3: 24 Hg
C) pH: 7.12, CO2: 47 mm Hg, HCO3: 32 mm Hh
D) pH: 7.39, CO2: 36 mm Hg, HCO3: 23 mm Hg

Question 22

A nurse evaluates the following arterial blood gas and vital sign results for a client with chronic
(COPD):
Arterial Blood Gas REsults
pH=7.32
paO2=46mm Hg
hCO3= 28 mEq/L vital signs
Respiratory rate = 10 breath/min
Blood pressure= 145/65 mm Hg
Heart rate= 110 beats/min
Oxygen saturation= 76% on room air
Which action should the nurse take first

A) Document finding as expected for a client with COP
B) Teach the client diaphragmatic breathing techniques
C) Administer a short-acting beta 2 agonist inhaler
D) Initiate oxygenation therapy and titrate oxygen to achieve a target oxygen saturation of

88-92%

Question 23

The health care provider has just prescribed warfarin sodium for a client with a deep vein
thrombosis (DVT). The nurse knows that his client is still receiving intravenous heparin. Which is
the nurse’s best action?

A) Discontinue the heparin drip completely before warfarin sodium administration.
B) Turn off the heparin drip for 1 hour before administering the warfarin sodium.
C) Hold the dose of warfarin sodium
D) Administer the medication as prescribed

Question 24

A client with chronic bronchitis who has a new prescription for fluticasone and salmeterol
combination inhaler asks the nurse the purpose of using tw drugs. Which is the best response
by the nurse?

A) The combination of two drugs work more quickly in an acute asthma attack
B) One drug decreases inflammation, and the other is a bronchodilator.
C) The two drugs work together to block the effects of histamine of the bronchioles
D) It is a combination of long-acting and slow-acting bronchodilators

Question 25

Which assessment finding for a client receiving furosemide 40 mg, twice daily to treat stage 2
hypertension is most important to

A) Blood glucose level of 180 mg/dl
B) Early morning blood pressure reading of 164/90 mm Hg
C) Orthostatic systolic blood pressure decrease of 30 mm Hg
D) Blood potassium level of 4.2 mEq/L

Question 26

Which findings are significant data to gather from a client who has been diagnosed with
pneumonia? ( select all that apply.)

A) Color of nail beds
B) Amount of peripheral edema
C) Occurrence of chest pain
D) Quality of breath sounds
E) Presence of bowel sounds

Question 28

The provider ordered normal Saline with 20 mEQ of KcL to infuse at 100 mL/hr. The first liter
bag was hung at 1500. What time does the nurse anticipate needing to hang the second bag of
Iv fluids? (record answer in military time.)

Answer: 0100

Question 29

A client is undergoing diagnostic testing for infective endocarditis. Which of the following
laboratory tests would be most useful in diagnosis?

A) Reticulocyte count
B) Blood cultures
C) Basic Metabolic panel
D) Prothrombin time

Question 30

Which of the following statements indicated a client’s understanding of managing their
obstructive apnea?

A) “It is possible that my sleep apnea can be corrected if I exercise and watch my diet.”
B) “Using modafinil can cure my obstructive sleep apnea.”

C) “I should wait to take my sleep aid until I am ready for bed.”
D) “I will stop using my continuous positive airway pressure machine if it makes too much

noise.”

Question 31

When a client with hypertension with a new prescription for atenolol returns to the health clinic
after two weeks for a follow-up visit, the blood pressure is unchanged from the previous visit.
Which action should the nurse take first?

A) Remind the client that lifestyle changes also are essential in blood pressure control
B) Teach the client about the reason for a possible change in drug therapy
C) Question the client about whether the medication is actually being taken
D) Provide information about the use of multiple drugs to treat hypertension

Question 32

A client with an acute exacerbation of chronic obstructive pulmonary disease (COPD) is
admitted to the hospital. How can the nurse best position the client to improve gas exchange?

A) Resting in bed in a semi-fowler’s position with the knees flexed.
B) Resting in bed with the head elevated 45 to 60 degrees.
C) In the Trendelenburg position with several pillows behind the head.
D) Sitting up at the bedside or in a chair and leaning slightly forward.

Question 33

A nurse is caring for a client who has valvular heart disease and is at risk of developing
left-sided heart failure. Which of the following manifestations should alert the nurse the client is
developing this condition?

A) Anorexia
B) Dependent edema
C) Orthopnea
D) Weight gain

Question 34

A nurse is assessing a male client who has a diagnosis of acute arterial occlusion. Which of the
following findings should the nurse expect to find on the affected extremity? (select all that
apply.)

A) Pallor
B) Paralysis

C) Paresthesia
D) Petechiae
E) Pulselessness
F) Pain

Question 35

Which of the following would the nurse most likely assess in a client diagnosed with right-sided
heart failure?

A) Syncope
B) Hepatomegaly
C) Crackles
D) Cough with frothy blood-tinged sputum

Question 36

The nurse is caring for a client diagnosed with chronic obstructive pulmonary disease. Which of
the following interventions require extra care by the nurse?

A) Teaching the client diaphragmatic breathing
B) Encouraging fluids
C) Apply a cardiac monitor
D) Administering pain medications

Question 37

A client is having a laboratory test conducted to confirm a diagnosis of atherosclerosis. Which of
the following laboratory values would support this client’s medical diagnosis? (select all that
apply.)

A) Triglycerides 175 mg/dL
B) Blood glucose 115 mg/dL
C) High-density lipoprotein (HDL) 50 mg/dL
D) Serum-cholesterol 195 mg/dL
E) Low-density lipoprotein (LDL) 145 mg/dL
F) Potassium 5.9 mEq/L

Question 38

Of the following client assignments made by the charge nurse, which would be questioned?

A) The RN with 1 year of experience caring for a post-appendectomy client
B) The LPN with 5 years of experience changing a chronic foley

C) The RN with eight years of experience caring for a client with peripheral vascularisation
disease and total cholesterol of 390 mg/dL

D) The LPN with ten years of experience caring for a client with new complaints of chest
pressure

Question 39

Which arterial blood gas (ABG) values are expected with hyperventilation?

A) pH 7.249; PaCO2 64 mmHg
B) pH 7.56; PaC02 25 mmHg
C) pH 7.50; paC02 50 mmHg
D) pH 7.28; PaCO2 28 mmHg

Question 40

The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which
requires immediate intervention?

A) Pursed-lip breathing
B) Inability to speak
C) Diminished lung sounds
D) Distant heart sounds

Question 41

A client with a history of aortic valve stenosis tell s the healthcare provider. “I don't have a lot of
energy anymore, and I have to sleep on 3 pillows at night.” Which of these problems does the
healthcare provider conclude is likely the cause of these clinical findings?

A) Left-sided heart failure
B) Right-sided heart failure
C) Peripheral venous disease

Question 42

A client is admitted to the hospital with a diagnosis of chronic venous insufficiency. Which of
these statements by the client is most consistent with the diagnosis?

A) “I can never seem to get my feet warm enough”
B) “I have pain in my legs after I walk three blocks”
C) “I should elevate my legs”
D) “I wake up during the night because my legs hurt”

Question 43

Which of the following medications should be used with caution in clients with asthma or chronic
obstructive pulmonary disease (COPD) due to their potential to cause bronchoconstriction?

A) Calcium channel blockers
B) Thiazide diuretics
C) Beta-blocker
D) ACE Inhibitors

Question 44
Which of the following should the nurse instruct a client newly diagnosed with hypertension on?

A) It can be managed easily
B) It is a short term problem
C) It is a lifelong process
D) It happens only in the very poor, and treatment is expensive

Question 45

The nurse assessing a client diagnosed with an abdominal aortic aneurysm (AAA). WHich of the
following sounds did the nurse likely auscultate during the assessment?

A) Bruit
B) Pleural rub
C) Crackles
D) Hyperactive bowel sounds

Question 46

A client is receiving an intravenous infusion of heparin sodium at 1,770 units/hr. The drug
concentration is heparin sodium 25,000 units/250ml. What is the rate (in mL/hr) the nurse must
infuse the medication at? (round the answer to the nearest whole number. Do not use a trailing
zero.)

Question 47

The nurse is assessing a 48-year-old client with a history of smoking during a routine clinic visit.
The client, who exercises regularly, reports having pain in the calf during the exercise that
disappears at rest. Which finding requires further evaluation?

A) Ankle-brachial index of 0.99
B) Oxygen saturation of 94% on room air
C) Diminished right pedal pulse
D) Heart rate 60 beats/minute

Question 48

The nurse is notifying the healthcare provider via telephone of a change in the condition of a
client diagnosed with exacerbation of asthma. Arrange the nursing statements in order as they
would by communicated using the SBAR method.
1.Mr.Smith was admitted yesterday with an exacerbation of asthma. He typically controls his
asthma with oral medication and inhaler at home. He orders albuterol treatments twice daily.
Oxygen is prescribed for a 2L nasal cannula.
2. I am notifying you because Bob Smith has become increasingly short of breath with audible
wheezing this afternoon.
3. I recommend that we increase his oxygen dose and prescribe an extra albuterol treatment.
4. Hello. My name is Nurse Jones from Unit D.
5. Respirations are now 32/minute. The pulse oximeter is 89% on 2 L nasal cannula. Lungs
reveal wheezing in all lung fields.

A) 4,5,1,2,3
B) 4,2,1,5,3
C) 4,1,2,5,3
D) 4,5,2,1,3

Question 49

The nurse is reviewing a medical record for a client with hypertension. Which of the following
medications may be used in the management of hypertension? (select all that apply)

A) Carvedilol
B) Hydrochlorothiazide
C) Ticagrelor
D) Loratadine
E) Verapamil
F) Valsartan

Question 50

Order for dobutamine to infuse at 20 mcg/kg/min. The client weighs 182 Ib. The pharmacy
supplied a bag of dobutamine 250 mg/250ml. What is the rate (in mL/hr) the nurse infuses the
medication at? (Round the answer to the nearest whole number. Do not use a trailing zero.)?

SOAP note

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Insomnia

week 2

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Choose a topic related to nursing education. You are to identify an issue, need, gap, or opportunity associated
with:
a. any issue in nursing education at any level (e.g. pre-licensure; post-licensure, graduate);
b. nursing education as it relates to a selected patient population; or
c. nursing education as it relates to healthcare administration. 

Assessment 3

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Assessment 3

Applying Ethical Principles

Competency 3

Apply ethical principles and academic standards to the study of health care.

Criterion

Summarize the facts of a case study using peer-reviewed journal articles as evidence to support analysis of the case.

Your Result: NON_PERFORMANCE

Does not summarize the facts of a case study using peer-reviewed journal articles as evidence to support analysis of the case.

Faculty Comments:

While you mention that the case study is one provided by Capella; unfortunately, you did not select one of the provided case studies that were listed in your instructions. Please review the written instructions and let me know if you have any questions.

Criterion

Discuss the effectiveness of the approach used by the professional in a case study as it relates to the three components of the ethical decision-making model.

Your Result: NON_PERFORMANCE

Does not discuss the effectiveness of the approach used by the professional in a case study as it relates to the three components of the ethical decision-making model.

Faculty Comments:

While you mention that the case study is one provided by Capella; unfortunately, you did not select one of the provided case studies that were listed in your instructions. Please review the written instructions and let me know if you have any questions.

Criterion

Apply ethical principles to a possible solution to the proposed problem or issue from a case study.

Your Result: NON_PERFORMANCE

Does not identify ethical principles related to the possible solution to the proposed problem or issue from the case study.

Faculty Comments:

While you mention that the case study is one provided by Capella; unfortunately, you did not select one of the provided case studies that were listed in your instructions. Please review the written instructions and let me know if you have any questions.

Competency 4

Write for a specific audience, in appropriate tone and style, in accordance with Capella's writing standards.

Criterion

Discuss the effectiveness of the communication approaches present in a case study.

Your Result: NON_PERFORMANCE

Does not discuss the effectiveness of the communication approaches present in a case study.

Faculty Comments:

While you mention that the case study is one provided by Capella; unfortunately, you did not select one of the provided case studies that were listed in your instructions. Please review the written instructions and let me know if you have any questions.

Criterion

Produce text with minimal grammatical, usage, spelling, and mechanical errors.

Your Result: BASIC

Produces text with some grammatical, usage, spelling, and mechanical errors, making text difficult to follow at times.

Faculty Comments:

Again, as mentioned in your previous assessment – your focus gets lost in your extravigant vocabulary. Please take a look at the example paper for ideas as to how your paper should look and sound.

Criterion

Integrate into text appropriate use of scholarly sources, evidence, and citation style.

Your Result: NON_PERFORMANCE

Does not integrate into text appropriate use of scholarly sources, evidence, and citation style.

Faculty Comments:

Your paper does not appear to be in APA format as discussed in the scoring guide of your previous assessment. Please utilize the resources provided to assist you with APA formatting. Additionally, you need to use literature that is recent and peer-reviewed. Resources should be 5 years old or less.

You should check two places for feedback from faculty: in the comments for each criterion above, and within the document itself, either as attached comments or within tracked changes.

Assessment 3 instructions

Introduction

Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.

Select the case most closely related to your area of interest and use it to complete the assessment.

Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.

Include the selected case study in your reference list, using proper APA style and format. Refer to the Evidence and APA section of the Writing Center for guidance.

Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.

Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.

Identify who is involved or affected by the ethical problem or issue.

Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.

Apply the three components outlined in the Ethical Decision-Making Model media.

Analyze the factors that contributed to the ethical problem or issue identified in the case study.

Describe the factors that contributed to the problem or issue and explain how they contributed.

Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.

In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.

Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.

Review the Think Critically About Source Quality resource.

Assess the credibility of the information source.

Assess the relevance of the information source.

Discuss the effectiveness of the communication approaches present in a case study.

Describe how the health care professional in the case study communicated with others.

Assess instances where the professional communicated effectively or ineffectively.

Explain which communication approaches should be used and which ones should be avoided.

Describe the consequences of using effective and non-effective communication approaches.

Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.

Describe the actions taken in response to the ethical dilemma or issue presented in the case study.

Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.

Discuss the key lessons this case provides for health care professionals.

Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.

Describe the proposed solution.

Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.

Discuss how likely it is the proposed solution will foster professional collaboration.

Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.

Apply the principles of effective composition.

Determine the proper application of the rules of grammar and mechanics.

Write using APA style for in-text citations, quotes, and references.

Determine the proper application of APA formatting requirements and scholarly writing standards.

Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Ethical Case Studies to use for this assignment

Consider the ethical dilemma the health care professional is faced with in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior).

Note: The case study may not supply all of the information you may need for the assignment. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make.

Case Study topic is the missing needle protector.

E. L. Straight is director of clinical services at Hopewell Hospital. As in many hospitals, a few physicians provide care that is acceptable, but not of very high quality; they tend to make more mistakes than the others and have a higher incidence of patients going “sour.” Since Straight took the position 2 years ago, new programs have been developed and things seem to be getting better in terms of quality.

Dr. Cutrite has practiced at Hopewell for longer than anyone can remember. Although once a brilliant general surgeon, he has slipped physically and mentally over the years, and Straight is contemplating taking steps to recommend a reduction in his privileges. However, the process is not complete, and Cutrite continues to perform a full range of procedures.

The operating room supervisor appeared at Straight's office one Monday afternoon. “We've got a problem,” she said, somewhat nonchalantly, but with a hint of disgust. “ I'm almost sure we left a plastic needle protector from a disposable syringe in a patient's belly, a Mrs. Jameson. You know, the protectors with the red–pink color. They'd be almost impossible to see if they were in a wound.”

“Where did it come from?” asked Straight.

“I'm not absolutely sure,” answered the supervisor. “All I know is that the syringe was among items in a used surgical pack when we did the count.” She went on to describe the safeguards of counts and records. The discrepancy was noted when records were reconciled at the end of the week. A surgical pack was shown as having a syringe, that was not supposed to be there. When the scrub nurse working with Cutrite was questioned, she remembered that he had used a syringe, but, when it was included in the count at the conclusion of surgery, she didn't think about the protective sheath, which must have been on it.

“Let's get Mrs. Jameson back into surgery.” said Straight. “We'll tell her it's necessary to check her incision and deep sutures. She'll never know we're really looking for the needle cover.”

“Too late,” responded the supervisor, “she went home day before yesterday.”

Oh, oh, thought Straight. Now what to do? “Have you talked to Dr. Cutrite?”

The supervisor nodded affirmatively. “He won't consider telling Mrs. Jameson there might be a problem and calling her back to the hospital,” she said. “And he warned us not to do anything either,” she added. “Dr. Cutrite claims it cannot possibly hurt her. Except for a little discomfort, she'll never know it's there.”

Straight called the chief of surgery and asked s hypothetical question about the consequences of leaving a small plastic cap in a patient's belly. The chief knew something was amiss but didn't pursue it. He simply replied there would likely be occasional discomfort, but probably no life–threatening consequences from leaving it in. “Although,” he added, “one never knows.”

Straight liked working at Hopewell Hospital and didn't relish crossing swords with Cutrite, who, although declining clinically, was politically very powerful. Straight had refrained from fingernail biting for years, but that old habit was suddenly overwhelming.

Nursing 8-3

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 Make a quality initiative proposal (7-10 PowerPoint slides) through a presentation, interpreting and communicating dashboard data to support the proposal.