...Mr. Apple has told you that his diagnosis of atrial fibrillation is recent and he understands he is on a blood thinner but he does not remember very much of what was taught to him about it. List three important teaching points that you want him to understand about this drug? The signs and symptoms of bleeding, how to prevent it, and how to stop it. Informing all medical personnel that he is taking Warfarin, including dental personnel. Signs and symptoms of unusual bleeding include bleeding gums, nosebleeds, black tarry stools, blood in his urine, and change of color or temperature. He should use a soft bristled toothbrush, avoid flossing, and use an electric razor to avoid bleeding. Bleeding, including venipuncture and injection sites, require...
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...program provided clinical skills so that a nurse could work in a clinical set up and do required tasks, it was all about looking after the patients, routine care and doing what the physician or practitioner told them to do. The most obvious reason nursing student chose to get their ADN is for the financial advantage and that it less time to complete their program. Many community colleges for nursing cost less money each semester to attend full time. Attending community college gives nursing students the chance to prepare for the financial demands of a 4-year university if they plan on transferring. If transferring were something the student would like to do. Some students are able to get scholarships and are able to transfer to a university. BSN nurses it different not only it is a 4-year degree it is more complex and gives you a different view of nursing. It takes nursing to a whole new level teaching them to think more critical, more in-depth, and to make decisions about their practice. BSN nursing also get the opportunity to further their education in more advanced profession for example becoming an anesthesia nurse or...
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...professional nurse (Creasia & Friberg, 2011). Over the past 40 years, the entry-level education and qualifications for nursing have been widely debated by the medical community (Institute of Medicine, 2011, p. 169). This essay serves to provide a comparative view of registered nurses prepared at the associate and baccalaureate levels, detailing the specific competencies of each. According to the Institute of Medicine, the ADN “prepares nurses to provide direct patient care and practice within the legal scope of professional nursing responsibilities in a variety of health care settings” (2011, p. 44). This includes the utilization of critical thinking in patient assessment and the implementation of interventions based on the individual plan of care and physician’s orders. Additionally, that ADN nurse is responsible for collaboration with other disciplines and patient advocacy. According to the Bureau of Labor Statistics (BLS, 2012), registered nurses also are responsible for educating and extending emotional support to patients, families, and the public....
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...Stroke Prevention Christina Thompson Grand Canyon Stroke Prevention What is a stroke? For my teaching plan I chose cognitive learning and so I created a poster-board and discussion on stroke explaining what a stroke is and signs and symptoms of one. The teaching itself consisted spending a lot of time at my community health department, specifically with the community health nurse, getting to know what their role is and how they accomplish much of what they do. She helped me set aside some time and a place to present the information. We did find it a little difficult with the demands of the assignment and their time because they had other obligations but were helpful and made time for me. They gave me suggestions and ideas and talked to me about the best approach for teaching my community would be receptive to. A poster board was discussed and decided upon after discussing the other options. They explained that most people in this learning group would not sit through a powerpoint and enjoy talking and telling their stories so with a poster-board they can browse and talk and pick up little take-aways. The nurse did explain that my local hospital that most of our community uses does not offer any free services and most of the services come from an adjacent hospital who provide them with a lot of free services and resources. So to be aware they will not appreciate where I am coming from but will appreciate that I am trying to learn. I also consulted with a teacher friend...
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...Difference In Competence Between Nurses With Associate Degree versus The Baccalaureate Degree nkechi oke Grand Canyon University: NRS-430V May 10, 2015 The purpose of Nursing education is to prepare individuals that have interest in the nursing profession to become nursing care professionals. Nursing education has an important value on the competence and knowledge achieved by the nurse and other health care professionals. Nursing has gradually developed in every direction of the healthcare field as well as the nursing roles in healthcare. Health care employers increasingly are recognizing that education makes a difference and are looking to hire nurses with higher education (Trautman 2015). Most employers want to hire nurses who can implement the latest research and evidence into practice, providing sensitive and quality care. An associate degree in nursing is a nursing degree that is usually awarded and obtained from the community college which typically takes two to three years to complete. In the 1970’s the associate degree in nursing (ADN) program helped to control and minimize the shortage of nurses there by encouraging facilities to educate their nurses in the community college. In 1951 nurse educator Mildred Montag proposed a new program to prepare nurse technicians in two year associate degree in the community colleges (Creasia and Friberg 2011). Graduates of the Associates Degree in Nursing (ADN) program must pass a national licensing examination, known...
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... The age of the client is of importance because of the effects age has on metabolism of drugs. If the older client can’t metabolize drugs effectively, the chance of drug toxicity is increased. The patient needs to be monitored and the medications titrated to therapeutic blood levels to ensure safety. Taking vital signs (V/S) before drug administration will give the nurse a baseline to guide therapy. It can also be an indicator of when medications should be held, or of possible adverse reactions to a drug. Knowing any cognitive barriers will help the nurse in making safe choices for the patient. The education of the patient may need to extend to family members or care takers. If the patient cannot identify adverse reactions, the teaching will have to be shared with whoever is around to identify these signs and symptoms. The life-long and numerous medications that accompany RA can be difficult to manage. Someone besides the client may need to administer medications. The nurse can explain the use of pill dispensers, setting alarms on telephones, or boldly marking a calendar for use in remembering doses. Due to the metabolism of these...
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... To better understand aspect of providing holistic nursing care one must have an in-depth understanding of primary body systems and their pathology. This paper will educate the prudent nurses who read it with detailed information about the specific cardiac pathology of atrial fibrillation. Written with a basic understanding of human heart function/structure as a prerequisite, this paper will first discuss key terms one must be familiar with before providing researched information explaining the pathophysiology of atrial fibrillation (AF). Next, it will discuss the etiology, clinical manifestations, common laboratory diagnostics, and interventions. Lastly, this paper continues by providing readers with nursing diagnoses and patient teachings associated with AF. Key Terms As a nurse one must become a scientist of sorts and must be familiar with technical nursing terminology. Atrial fibrillation, or AF, is a cardiac dysrhythmia in which “multiple rapid impulses from many atrial foci depolarize the atria in a totally disorganized manner at a rate of 350 to 600 times per minute” [ (Ignatavicius & Workman, 2010) ]. A dysrhythmia is a disorder of the heartbeat involving a disturbance in cardiac rhythm and an irregular heartbeat; whereas an arrhythmia is basically a fast or irregular heartbeat caused by a disorder in the heart's electrical system. Tachydysrhythmia is an abnormal heart rhythm with a rate greater than 100 beats per minute. Cardiac output refers to the...
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...Medicines Policy Geneva, Switzerland Authors Hans V. Hogerzeil1 (Editor) Karen I. Barnes2 Rob H. Henning3 Yunus E. Kocabasoglu3 Helene Möller4 Anthony J. Smith5 Rob S. Summers6 Theo P.G.M. de Vries7 with contributions from Hannelie Meyer, Sule Oktay, Budiono Santoso and Sri Suryawati 1 2 3 4 5 6 7 WHO Department of Essential Drugs and Medicines Policy, Geneva, Switzerland WHO Collaborating Centre for Drug Policy, Information and Safety Monitoring, Department of Clinical Pharmacology, Medical School, University of Cape Town, Cape Town, South Africa WHO Collaborating Centre for Pharmacotherapy Teaching and Training, Department of Pharmacology and Clinical Pharmacology, Medical Faculty, Groningen University, Groningen, The Netherlands WHO, South African Drug Action Programme, Pretoria, South Africa WHO Collaborating Centre for Pharmacotherapy Teaching and Training, Discipline of Clinical Pharmacology, Medical School, Newcastle, Australia WHO Collaborating Centre for Pharmacy Curriculum Development and Rational Use of Drugs, School of Pharmacy, Medical University of Southern Africa, Pretoria, South Africa Department of Pharmacology, Medical Faculty, University of Amsterdam, Amsterdam, The Netherlands Acknowledgements The support of the following persons in reviewing earlier drafts of this book is gratefully acknowledged: F. Danish (Kabul, Afghanistan), A. Haeri (Tehran, Islamic Republic of Iran), A. Helali (Algiers, Algeria), K.K. Kafle (Kathmandu, Nepal),...
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...Dale Gordon has been a patient in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him. Joan assesses Mr. Gordon using the Braden Scale and determines that his score is 12. What does this score indicate about Mr. Gordon’s pressure ulcer risk? Joan is assessing Mr. Gordon’s skin and notices that he has a 3 cm blister and a shallow crater on his buttock. Mr. Gordon winces when Joan palpates the area. How should Joan stage this area? A. Stage I pressure ulcer B. Stage II pressure ulcer C. Stage III pressure ulcer D. Stage IV pressure ulcer Rationale: Mr. Gordon has drainage coming from his surgical incision, and his dressing needs to be changed. What assessments of the incision should Joan perform while changing? Answer: Rationale: Claudia asks Joan what she can do when she takes him home to help prevent...
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...Critical Care Case Study Crystal Meyer Mohave Community College Nursing 222 Mrs. Michelle Christensen April 1, 2014 Critical Care Case Study ADMISSION TC is a 61-year-old English speaking Caucasian female born on April 29, 1952. She weighs 99.7 Kg and is 5 feet, 5 inches in height with a BMI of 35.84. On March 5, 2014, TC was brought into the emergency department after her daughter-in-law called 911 when she found TC unresponsive at home in her bathroom. When paramedics arrived, she was found to be cool, pale, and diaphoretic with oxygen saturations in the high 70’s. Emergency responders placed a non-rebreather high flow oxygen mask and her oxygenation began to improve with saturations in the low 90’s. Upon arrival to the emergency department, TC’s vital signs were as follows: T 97.4; P 97; BP 120/95 mm Hg; RR 15 per minute; and O2 sats of 98% via NRB oxygen mask on 8L. A chest x-ray (CXR) revealed no abnormality and lungs were determined to be grossly clear. However, TC was checked for a pulmonary embolism via a pulmonary artery angiogram with IV contrast and found to have a large clot burden with a small saddle embolism. TC also complained of right ankle pain. An X-ray of her right ankle revealed a distal tib/fib fracture, which was presumed to be related to her fall during her hypoxic episode. With these findings, TC was admitted to the Intensive Care Unit of Kingman Regional Medical Center and placed on an NPO diet in preparation for placement of an inferior vena...
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...Assignment: Assessment 1 M, L Health Care Provider: A P Sex: M Weight: 255 lbs 12 oz Code Status: 02 Isolation: 00 Food Allergies: 00 Diet: 01 Hospital Floor: Age: 62 Y Height: 6' Alerts: 00 Drug Allergies: 00 Env. Allergies: 00 BMI: 34.7 Medical-Surgical Student: Marlen Flores Assignment: Assessment 1 Submitted: 02/16/2016 15:49 Clinical Assignment Grading Assignment Objectives No assignment objectives entered. Clinical Set-up Details First Day of Clinical: 02/10/2016 Primary Diagnosis: Chronic obstructive pulmonary disease (COPD) Provider Name: P, A Secondary Diagnosis: Student Details: Patient Details: First Initial: M Identifier 1: L Last Name: Flores Identifier 2: M Credentials: SNPC Gender: M Age: 62 Years Pre-Clinical Manager Patient Info Identifier: M, L Gender: M Age: 62 Y Nurse Initials: M Flores, SNPC Diagnosis (1) Primary Diagnosis: Chronic obstructive pulmonary disease (COPD) Patho-Physiology: A progressive disease that is associated with difficulty breathing due to severe injuries to the pulmonary alveoli. The cause of this disease is the continuous exposure to cigarette smoke either actively or passively, and contaminated environments which reduces the shortness of breath and chest tightness. COPD may appear as two distinct disorders: emphysema and chronic bronchitis. Emphysema is the broadening of the alveoli and the destruction...
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...Chapter 1 The Patient Interview Sneha Baxi Srivastava, PharmD, BCACP Learning Objectives • Explain the basic communication skills needed when performing a patient interview. • Describe the components of the patient interview. • Conduct a thorough medication history. • Compare and contrast the different patient interview approaches in various clinical settings. • Adapt the interview technique based on the needs of the patient. Key Terms • Active Listening • Rapport • Empathy • Open-Ended Questions • Leading Questions • Probing Questions • Nonverbal Communication • Chief Complaint • History of Present Illness • Pertinent Positive • Pertinent Negative • Past History • Medication History • Family History • Personal and Social History • Review of Systems • Physical Exam • QuEST/SCHOLAR-MAC Introduction The patient interview is the primary way of obtaining comprehensive information about the patient in order to provide effective patient-centered care, and the medication history component is the pharmacist’s expertise. A methodological approach is used to obtain information from the patient, usually starting with determining the patient’s chief complaint, also known as the reason for the healthcare visit, and then 2 Chapter 1 / The Patient Interview delving further into an exploration of the patient’s specific complaint and problem. A comprehensive patient interview includes inquiring about the patient’s...
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...PN MENTAL HEALTH NURSING EDITION . CO NT ASTERY SERI ES TM N E R EV MOD IE W LE U PN Mental Health Nursing Review Module Edition 9.0 CONtriButOrs Sheryl Sommer, PhD, RN, CNE VP Nursing Education & Strategy Janean Johnson, MSN, RN Nursing Education Strategist Sherry L. Roper, PhD, RN Nursing Education Strategist Karin Roberts, PhD, MSN, RN, CNE Nursing Education Coordinator Mendy G. McMichael, DNP, RN Nursing Education Specialist and Content Project Coordinator Marsha S. Barlow, MSN, RN Nursing Education Specialist Norma Jean Henry, MSN/Ed, RN Nursing Education Specialist eDitOrial aND PuBlisHiNg Derek Prater Spring Lenox Michelle Renner Mandy Tallmadge Kelly Von Lunen CONsultaNts Deb Johnson-Schuh, RN, MSN, CNE Loraine White, RN, BSN, MA PN MeNtal HealtH NursiNg i PN MeNtal HealtH NursiNg review Module editioN 9.0 intellectual Property Notice ATI Nursing is a division of Assessment Technologies Institute®, LLC Copyright © 2014 Assessment Technologies Institute, LLC. All rights reserved. The reproduction of this work in any electronic, mechanical or other means, now known or hereafter invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the content in this publication, including, for example, the cover, all of the page headers, images, illustrations, graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual property rights or licenses...
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...NCSBN ON-LINE REVIEW 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. reason for the nurse to elevate the casted leg is to A) Promote the client's comfort B) Reduce the drying time C) Decrease irritation to the skin D) Improve venous return The most important D: Improve venous return. Elevating the leg both improves venous return and reduces swelling. Client comfort will be improved as well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client? A) B) C) D) Clean the meatus, begin voiding, then catch urine stream Void a little, clean the meatus, then collect specimen Clean the meatus, then urinate into container Void continuously and catch some of the urine A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it’s best to just slip the container into the stream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should the nurse see first? A) B) C) D) 16 year-old who had an open reduction of a fractured wrist 10 hours ago 20 year-old...
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...ACKNOWLEDGEMENT * INTRODUCTION CHAPTER ONE: OVERVIEW OF CLIENT SITUATION I. Literature review of gestational trophoblastic neoplasm CHAPTER TWO: COMPREHENSIVE HOLISTIC ASSESSMENT OF PATIENT/FAMILY I. Patient’s medical and personal history including review of the systems II.Physical examination III.Diagnostic evaluation IV.Nutritional assessment V. Psychosocial history VI. Patient developmental assessment VII.Spiritual assessment VIII.Quality of life assessment IX.Admission of patient CHAPTER THREE: ANALYSIS OF DATA CHAPTER FOUR: COLLABORATIVE PLAN OF CARE I. Presumptive medical diagnosis II.Nursing diagnosis III.Evidence-based interventions IV.Additional diagnostic procedures warranted but not done Medication to be ordered CHAPTER FIVE: DISCHARGE PLAN I. Community service and resource needed II.Client education plan III.Plans for follow-up of care CHAPTER SIX: EVALUATION PLAN Termination of care * SUMMARY * CONCLUSION * REFERENCE PREFACE The patient / family care study is an essential and relevant study undertaken on the patient and the family by a final year nursing student as part of the required curriculum to complete the Master of science in Advance Nursing Practice program Advanced Practice Nurses (APN) play a pivotal role in assisting patients through the disease process. From the time of diagnosis through the...
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