Skip to content
1. Describe how the roles of a nurse anesthetist, clinical nurse specialist, nurse practitioner, and nurse midwife differ.
2. Describe the various medication errors that can occur in the administration of medications.
3. If a nurse disagrees with a physician’s written orders, discuss what action the nurse should take to protect the patient’s safety. What case law supports your recommendations?
Describe your clinical experience for this week at a pediatric office.
Did you face any challenges, any success? If so, what were they?
Describe the assessment of a patient, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
Mention the health promotion intervention for this patient.
What did you learn from this week’s clinical experience that can beneficial for you as an advanced practice nurse?
Support your plan of care with the current peer-reviewed research guideline
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.
Introduction and conclusion
AC is a 72-year-old male who is admitted to your ICU after suffering a massive stroke that has left him unresponsive and unable to communicate. He is currently on a ventilator. It was discovered that the stroke was the result of a medication error. His wife of 48 years is available along with their one adult daughter. The wife informs you that they don’t have any advanced directives, but she is “pretty sure her husband would not want to live like this.” However, their daughter is adamant her dad would want to be kept alive in case there is any chance to come out of thi
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.
Introduction and conclusion
AC is a 72-year-old male who is admitted to your ICU after suffering a massive stroke that has left him unresponsive and unable to communicate. He is currently on a ventilator. It was discovered that the stroke was the result of a medication error. His wife of 48 years is available along with their one adult daughter. The wife informs you that they don’t have any advanced directives, but she is “pretty sure her husband would not want to live like this.” However, their daughter is adamant her dad would want to be kept alive in case there is any chance to come out of thi
CASE STUDY: Family Member with Alzheimer’s Disease: Mark and Jacqueline
Mark and Jacqueline have been married for 30 years. They have grown children who live in another
state. Jacqueline’s mother has moved in with the couple because she has Alzheimer’s disease.
Jacqueline is an only child and always promised her mother that she would care for her in her old
age. Her mother is unaware of her surroundings and often calls out for her daughter Jackie when
Jacqueline is in the room. Jacqueline reassures her mother that she is there to help, but to no avail.
Jacqueline is unable to visit her children on holidays because she must attend to her mother’s daily
needs. She is reluctant to visit friends or even go out to a movie because of her mother’s care needs
or because she is too tired. Even though she has eliminated most leisure activities with Mark,
Jacqueline goes to bed at night with many of her caregiving tasks unfinished. She tries to visit with
her mother during the day, but her mother rejects any contact with her daughter. Planning for the
upcoming holidays seems impossible to Mark, because of his wife’s inability to focus on anything
except her mother’s care.
Jacqueline has difficulty sleeping at night and is unable to discuss plans even a few days in
advance. She is unable to visit friends and is reluctant to have friends visit because of the
unpredictable behavior of her mother and her need to attend to the daily care.
Reflective Questions
1. How do you think this situation reflects Jacqueline’s sense of role performance?
2. How do you think that Jacqueline may be contributing to her own health?
CASE STUDY: Family Member with Alzheimer’s Disease: Mark and Jacqueline
Mark and Jacqueline have been married for 30 years. They have grown children who live in another
state. Jacqueline’s mother has moved in with the couple because she has Alzheimer’s disease.
Jacqueline is an only child and always promised her mother that she would care for her in her old
age. Her mother is unaware of her surroundings and often calls out for her daughter Jackie when
Jacqueline is in the room. Jacqueline reassures her mother that she is there to help, but to no avail.
Jacqueline is unable to visit her children on holidays because she must attend to her mother’s daily
needs. She is reluctant to visit friends or even go out to a movie because of her mother’s care needs
or because she is too tired. Even though she has eliminated most leisure activities with Mark,
Jacqueline goes to bed at night with many of her caregiving tasks unfinished. She tries to visit with
her mother during the day, but her mother rejects any contact with her daughter. Planning for the
upcoming holidays seems impossible to Mark, because of his wife’s inability to focus on anything
except her mother’s care.
Jacqueline has difficulty sleeping at night and is unable to discuss plans even a few days in
advance. She is unable to visit friends and is reluctant to have friends visit because of the
unpredictable behavior of her mother and her need to attend to the daily care.
Reflective Questions
1. How do you think this situation reflects Jacqueline’s sense of role performance?
2. How do you think that Jacqueline may be contributing to her own health?
Write a 1-2 page typed journal submission regarding your thoughts about the use of palliative and hospice care as an option for health promotion. In your journal submission, you must demonstrate an understanding of each; palliative and hospice care, as they are not the same. In what scenario(s) and levels of care might this be applicable? Have you ever thought about palliative and hospice care promoting health? Why or why not? Please include specific examples from the video and how this sways your opinion.
The purpose of this assignment is to provide the students an opportunity to develop an in-depth understanding of a specific disease process.
Assignment Details:
Perform the following tasks:
Students will select a specific disease process from one of the units of study. The paper should have three parts. The first should be an in-depth discussion of the disease process including the pathophysiology and clinical manifestations. The second part is an analysis of a case study. The third part is the flow diagram. The specific case can be actual or imagined. The case study analysis should include a description of the case, signs and symptoms, diagnostic tests utilized, treatment, nursing care plan, potential outcomes, evaluation, and flow diagram. The paper should be 10-15 typed pages in length. This does not include the title page or reference page. The paper is to be in APA format and grammatically correct.
Flow Diagram
The flow diagram is designed to assist the student to apply physiological and pathophysiological concepts in identifying the underlying mechanisms that result in the signs and symptoms (clinical manifestations) of illness. This understanding serves as part of the knowledge base that will assist students to apply the nursing process in the care of patients.
What is a Flow Diagram?
A flow diagram is a simple method of showing relationships. Through the use of arrows and sequencing of events, the student can identify the source (risk factors), pathophysiologic changes occurring in the body resulting in the patient’s typical signs and symptoms as we know them today. As knowledge changes, the student is then able to modify his thinking based upon new information. Usually a medical diagnosis is used as the topic to diagram, although this can be done with normal homeodynamic mechanisms or such events as tissue trauma related to a surgical procedure.
Why use Flow Diagrams (instead of written text)?
A Flow Diagram emphasizes causal relationships. Each arrow indicates a cause. What causes the organ damage? How did the injury cause the specific clinical manifestation(s)? What signs or symptoms were caused by adaptive responses? Diagramming will enhance memory links and conceptual understanding of the sequencing of events. This technique will be useful to you as a lifelong learner.
Outline of Flow Diagram
Top of Page: Title of Flow Diagram such as is the disease process “Angina Pectoris.” Students may use the same topic used in the Case Study Analysis.
Antecedents: Risk factors that lead to the development of the disease (etiology). Use arrows from antecedents to actions to patient’s signs and symptoms.
Actions: The body’s response to the pathology or stimulation of adaptive responses. Include cellular level. Include appropriate terms related to anatomy and physiology.
Clinical Manifestations: The subjective and objective data you would expect to observe in a patient with this condition. At this point, you should be able to explain visually why your patient has chest pain. Include abnormal lab findings if appropriate.
Three Nursing Diagnoses: Identify three Nursing Diagnoses that could be developed based upon the flow diagram. Arrow(s) should go from the sign and symptom(s) to the Nursing Diagnosis.
Grading:
Disease Process (30 points)
Pathophysiology 20 points
Clinical Manifestations 10 points
Case Study (45 points)
Description of case including signs and symptoms, diagnostic tests 10 points
Treatment 10 points
Nursing Care Plan (include all areas) 15 points
Potential Outcomes 10 points
The purpose of this assignment is to provide the students an opportunity to develop an in-depth understanding of a specific disease process.
Assignment Details:
Perform the following tasks:
Students will select a specific disease process from one of the units of study. The paper should have three parts. The first should be an in-depth discussion of the disease process including the pathophysiology and clinical manifestations. The second part is an analysis of a case study. The third part is the flow diagram. The specific case can be actual or imagined. The case study analysis should include a description of the case, signs and symptoms, diagnostic tests utilized, treatment, nursing care plan, potential outcomes, evaluation, and flow diagram. The paper should be 10-15 typed pages in length. This does not include the title page or reference page. The paper is to be in APA format and grammatically correct.
Flow Diagram
The flow diagram is designed to assist the student to apply physiological and pathophysiological concepts in identifying the underlying mechanisms that result in the signs and symptoms (clinical manifestations) of illness. This understanding serves as part of the knowledge base that will assist students to apply the nursing process in the care of patients.
What is a Flow Diagram?
A flow diagram is a simple method of showing relationships. Through the use of arrows and sequencing of events, the student can identify the source (risk factors), pathophysiologic changes occurring in the body resulting in the patient’s typical signs and symptoms as we know them today. As knowledge changes, the student is then able to modify his thinking based upon new information. Usually a medical diagnosis is used as the topic to diagram, although this can be done with normal homeodynamic mechanisms or such events as tissue trauma related to a surgical procedure.
Why use Flow Diagrams (instead of written text)?
A Flow Diagram emphasizes causal relationships. Each arrow indicates a cause. What causes the organ damage? How did the injury cause the specific clinical manifestation(s)? What signs or symptoms were caused by adaptive responses? Diagramming will enhance memory links and conceptual understanding of the sequencing of events. This technique will be useful to you as a lifelong learner.
Outline of Flow Diagram
Top of Page: Title of Flow Diagram such as is the disease process “Angina Pectoris.” Students may use the same topic used in the Case Study Analysis.
Antecedents: Risk factors that lead to the development of the disease (etiology). Use arrows from antecedents to actions to patient’s signs and symptoms.
Actions: The body’s response to the pathology or stimulation of adaptive responses. Include cellular level. Include appropriate terms related to anatomy and physiology.
Clinical Manifestations: The subjective and objective data you would expect to observe in a patient with this condition. At this point, you should be able to explain visually why your patient has chest pain. Include abnormal lab findings if appropriate.
Three Nursing Diagnoses: Identify three Nursing Diagnoses that could be developed based upon the flow diagram. Arrow(s) should go from the sign and symptom(s) to the Nursing Diagnosis.
Grading:
Disease Process (30 points)
Pathophysiology 20 points
Clinical Manifestations 10 points
Case Study (45 points)
Description of case including signs and symptoms, diagnostic tests 10 points
Treatment 10 points
Nursing Care Plan (include all areas) 15 points
Potential Outcomes 10 points
This is your first week as an RN in a small rural hospital. You work the night shift on a medical-surgical unit. Tonight your only unlicensed assistive personnel (UAP) and a staff nurse have called in sick, which makes the unit short-staffed. You have notified the night supervisor that you need help, and she sends a USP from another floor to assist you. She tells you she can send another nurse in about an hour, and instructs you to take care of the priority cases until that time.
You have six relatively uncomplicated patients; caring for them involves checking their vital signs and giving medications. You instruct the aide to obtain vital signs for these patients and report the results back to you. A quick review of the medications reveals nothing that is urgent; you can wait and have the second nurse administer the medications when he or she arrives. You have four other patients with more complicated issues, who require additional assessments and urgent care:
• George Patel, a 64-year-old patient with a tracheostomy, has gurgling sounds coming from his tracheostomy and a frequent, nonproductive cough. His oxygen saturation level via pulse oximetry is 88%. You have orders to suction his tracheostomy prn.
• Gwen Galloway had been receiving chemotherapy and has now come back to the hospital with gastroenteritis. When you arrive on your shift, she is experiencing bouts of nausea and vomiting.
• Claudia Tran, an 84-year-old patient from a skilled nursing unit, is post-CVA. She has a stage III pressure injury on her coccyx and a stage I pressure injury on her left hip. She needs to be turned every 30 minutes because of rapidly developing erythema on bony prominences. She is confused and has fallen the past two nights when left unattended, even with implementation of fall precautions. Her family is visiting her now but plans to leave in 30 minutes.
• James White has COPD. The UAP reports that the blood pressure from the automatic cuff is 168/100 mm Hg; his baseline is usually 130/70 mm Hg. The UAP also reports that he is complaining of a severe headache, but has no other complaints.
Identify the order in which you would provide care to these patients. Explain your rationales as well as your interventions.