Pneumonia

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Pneumonia

Instructions

For this assignment, you will complete a Basic Concept Map based on an exemplar condition, disorder, or disease process. The Concept Map will include the following:

  • Assessment Data
    • Recognizing cues, consider subjective and objective data.
    • Analyze cues
  • Prioritize hypothesis
    • Should be prioritized based on the most urgent/important
  • Generate solutions for each prioritized problem
  • Take action
    • Interventions with Rationale
      • Must cite rationale
  • Evaluation

Template

Teaching Project Guidelines

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Teaching Project Guidelines

· Purpose: The purpose of the patient/family teaching project is to develop and implement a teaching plan for a geriatric patient utilizing teaching learning principles.

· Objectives: By the conclusion of the presentation, the students will be able to:

· State the various indications for a specified diet

· Explain the scientific rationale for a prescribed diet

· Describe food/fluid restrictions appropriate for diet or food/fluids encouraged to meet nutritional needs?

· Describe how to present a short nutritional teaching plan to a patient& family with cultural differences.

· Apply current research related to the nutrition topic.

· Requirements:

· Utilize teaching experience rubric for essential criteria.

· The paper should be between 3-5 pages (not including title page and references).

· The paper must be typed and conform to APA format.

· A minimum of two references are required.

· Written paper is due during the 7th week on the assigned clinical day.

 

Nutritional Guidelines

The student will be assigned one therapeutic diet from the following list.

1. Diabetic diet

2. Fat restricted and cholesterol restricted

3. Enteral nutrition

4. Sodium restricted

5. Total parental nutrition

6. Modified fiber and bland diets

7. Full and clear liquid diets

8. Nutrition in wasting diseases

9. Modified calcium and potassium diets

10. Dysphagic diet

11. Protein restricted diet

12. Anticoagulant diet

13. Follow the teaching/nutrition project evaluation tool criteria.

Develop, in detail, a situation in which a health care worker might be confronted with ethical problems related to patients and prescription drug use OR patients in a state of poverty.

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Instructions

Develop, in detail, a situation in which a health care worker might be confronted with ethical problems related to patients and prescription drug use OR patients in a state of poverty.

  • Your scenario must be original to you and this assignment. It cannot be from the discussion boards in this class or any other previous forum.
  • Articulate (and then assess) the ethical solutions that can found using “care” (care-based ethics) and “rights” ethics to those problems.
  • Assessment must ask if the solutions are flawed, practicable, persuasive, etc.
  • What health care technology is involved in the situation? What moral guidelines for using that kind of healthcare technology should be used there? Explore such guidelines also using utilitarianism, Kantian deontology, ethical egoism, or social contract ethics.
  • Say how social technologies such as blogs, crowdfunding, online encyclopedias can be used in either case. What moral guidelines for using that kind of healthcare technology should be used there? Develop such guidelines also using utilitarianism, Kantian deontology, ethical egoism, or social contract ethics.

You should not be using any text you used in a discussion board or assignment for this class or any previous class.

Cite the textbook and incorporate outside sources, including citations.

Requirements

  • Length: 3-4 pages (not including title page or references page)
  • 1-inch margins
  • Double spaced
  • 12-point Times New Roman font
  • Title page
  • References page (minimum of 2 scholarly sources)

Grading

This activity will be graded based on the Assignment Grading Rubric.

Outcomes

CO 7: Assess the moral solutions arrived at through “care” (care-based ethics) and “rights” ethics to social issues of ethical import such as poverty, drug use, lack of health care, and similar issues.

CO 8: Develop moral guidelines for using key recent and emerging healthcare and social technologies based on moral theories such as utilitarianism, deontology, virtue ethics, care-based ethics, ethical egoism, social contract theory, etc.

The role of nursing in research analysis for improving practice environments and patient outcomes cannot be understated.

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content

  1. The role of nursing in research analysis for improving practice environments and patient outcomes cannot be understated. As you might be aware, research outcomes play a major role in evidence-based nursing practice. You will be formulating research questions; collecting, summarizing, and interpreting data; and understanding the elements of research design.

    For this assessment, you develop a research proposal using the research question you developed by completing the Research Foundations worksheet. As you develop a research proposal, you must consider the ethical issues related to it.

    Determine the ethical considerations related to the research question you developed as part of your Research Foundations worksheet.

    Consider the 7 main principles of ethical research introduced in the learning activities section, Research Ethics Guidance (found at National Institutes of Health Patient Recruitment). Be sure to address the role cultural diversity might play in your research. The 7 main principles of ethical research are:

    • Social and clinical value
    • Scientific validity
    • Fair subject selection
    • Favorable risk-benefit ratio
    • Independent review
    • Informed consent
    • Respect for potential and enrolled subjects
    • Summarize the ethical issues related to your research topic in one of the following formats:
    • 18- to 20-slide Microsoft® PowerPoint® presentation
    • The slides themselves should only contain essential information and as little text as possible. Do not design a slide presentation made up of long bullet points. Your speaker notes convey the details you would give if you were presenting. See the Create Speaker Notes section of the PowerPoint 2013 Training video.
    • Record and upload a video of a 15- to 20-minute oral presentation. Review the How to Record High-Quality Videos for Online Courses at Home article for helpful techniques on how to record your video.
    • Cite at least 1 peer-reviewed and 1 evidence-based resource according to APA guidelines. Use the APA Style Guide 7th ed.

Follow the Soap Note Rubric as a guide

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Follow the Soap Note Rubric as a guide

Use APA format and must include a minimum of 2 Scholarly Citations.

Must be your own work and in your own words.

The use of templates is ok with regards to Turn it in, but the Patient History, CC, HPI, Assessment, and Plan should be of your own work and individualized to your made-up patient. 

diabetes mellitus

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An older client was recently discharged from the hospital for evaluation of seizure activity. His history reveals that he has late-stage Alzheimer’s disease, Parkinson’s disease, hypertension, and type II diabetes mellitus, which is controlled by diet. He lives at home, where his wife and daughter take care of him. His discharge medications include phenytoin (Dilantin), 100 mg BID; hydrochlorothiazide (HydroDIURIL), 50 mg QD; levodopa (Sinemet), 25/100 TID; and haloperidol (Haldol), 1 mg before bed. The client has been referred for home care nursing follow-up.

Questions:

  1. On the initial home visit by the nurse, what assessments should be made?
  2. The wife and daughter need teaching about his antiepileptic medication. What teaching should be included?
  3. During the initial home visit, the client experiences a generalized seizure. What action should the nurse take?

Case Study: Roslyn, a six-year-old, is attending public school for the first time.

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Case Study: Roslyn, a six-year-old, is attending public school for the first time. Her parents brought her to the clinic and stated, “she appears to have pain in her legs and won’t participate in playtime.” The parents noticed recently Roslyn appears pale and acts weak. Roslyn is diagnosed with sickle cell anemia. After her parents and siblings undergo genetic testing, it is found that Roslyn is the only family member with the disease.

  • What are the priority nursing interventions for Roslyn?
  • What anticipatory guidance should the nurse provide Roslyn and her family regarding the diagnosis of sickle cell anemia and her attending school?
  • How can the nurse support the child and family?
  • What discharge instructions should the nurse provide to Roslyn and her parents?
  • What, if any, activity restrictions will Roslyn have after discharge?

What are the three most important things you learned this week?

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What are the three most important things you learned this week?

What questions remain uppermost in your mind?

Is there anything you did not understand?

Just a few sentences for each question based on powerpoint

Depressive disorders

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Announcements

Office hours – Wed Feb 22 at 1030am

Writing the HPI and other note writing resources

APA surviving residency guide

Canvas

Course related questions?

 

What were your takeaways from the learning materials?

Podcast – diet and exercise as treatments

Quiz question #5 – depressive disorder due to another medical condition

TMS/ECT/ketamine treatment – research is ongoing, effects of ketamine are variable, ECT is effective, past hx of efficacy of ECT can predict future outcomes

Refer for ECT/TMS evaluation

Differences between MDD and dysthymia – diagnoses can co-exist, may change diagnoses over time

ECT for treatment resistant cases

DSM description of co-existing diagnoses – something like bereavement can cause symptoms that meet criteria for MDD

 

 

What questions do you have?

When is ECT recommended/used?

What would warrant ECT during pregnancy?

Anticonvulsants during ECT – hold the night before treatment

Is a seizure disorder a contraindication to ECT? No?

 

 

Review of pathophysiology of depressive disorders

What can contribute to depressive symptoms?

Heterogeneous diagnostic category

The only depressive disorders diagnoses that require a certain etiology are medication/substance induced and due to a medical condition

 

Assessing patients presenting with depressive symptoms

Terminology: Depressed vs. distressed

Communication approaches

Other factors: Grief and loss, stress, trauma, medical conditions

Specific symptomatology

Duration and course of illness

Appearance on MSE

SAFE-T

 

Treatment options

It’s not all about medication

What are other evidence based treatment recommendations?

How to make treatment decisions

How to talk about these with patients

 

DSM Depressive disorders category

Disruptive mood dysregulation disorder (DMDD)

Major depressive disorder (MDD)

Persistent depressive disorder (dysthymia)

Premenstrual dysphoric disorder

Substance/medication induced depressive disorder

Depressive disorder due to another medical condition

Other specified depressive disorder

Unspecified depressive disorder

 

DMDD (F34.8)

History of this diagnosis (new to DSM-5)

Diagnosed between the ages of 6 and 18, age of onset before 10

Severe recurrent temper outbursts that are not developmentally appropriate

Differentiating between mood elevation/mania/hypomania

Childhood bipolar should not be diagnosed based on irritability, distractibility, poor judgment

Elated mood, decreased need for sleep (not the same as insomnia), and episodicity are more diagnostic

Note mutually exclusive diagnoses: ODD, IED, bipolar

Can be diagnosed along with: MDD, ADHD, substance use disorders, conduct disorder

 

MDD (F32 [single episode] or 33 [recurrent episodes] plus

Heterogenous diagnostic category, several diagnoses were combined in DSM-III

Can be episodic or chronic based on DSM criteria

At least 5 criteria need to be met (must incl. depressed mood OR loss of interest or pleasure), at least two weeks, change from previous level of functioning

Mutually exclusive with psychotic disorders (but there is MDD with psychotic features)

No history of manic or hypomanic episodes

Specifiers (next slide)

 

Specifiers

With anxious distress

With mixed features – includes at least 3 specific manic/hypomanic symptoms present nearly every day for the majority of days of the MDE

With melancholic features

With atypical features

With mood congruent or mood incongruent psychotic features

With catatonia

With peripartum onset

With seasonal pattern

In partial remission, in full remission

Mild, moderate, severe

 

Dysthymia (F34.1)

Used to be considered a personality trait (depressive personality disorder)

Depressed mood more days than not for at least 2 years (chronic)

In children/adolescents, mood can be irritable and lasting 1 year

Also needs 2 or more of 6 other symptoms

If full criteria for MDD have been met at some point, MDD should be diagnosed

No manic or hypomanic episodes or cyclothymia or psychotic disorders

Specifiers (next slide)

 

Dysthymia specifiers

Many are the same as MDD

With early onset (prior to age 21), with late onset (21 or older)

With pure dysthymic syndrome

With persistent MDE

With intermittent MDE, with current episode

With intermittent MDE, without current episode

 

Premenstrual dysphoric disorder (N94.3)

In the majority of menstrual cycles in the past year, at least 5 symptoms must be present in the week before the onset of menses and improve with onset of menses

Symptoms are not the result of an exacerbation of another disorder

 

Substance/medication induced depressive disorder (various ICDs)

Prominent and persistent disturbance in mood, includes depressed mood or anhedonia

Requires direct evidence that symptoms developed after exposure to the substance, and the substance is capable of producing the symptoms

Not better explained by a different depressive disorder

Does not occur during delirium

 

Depressive disorder due to another medical condition (F06.31, 32, or 34)

Mood symptoms must be the direct physiologic effect of the medical condition

Symptoms are not better explained by another disorder

Does not occur in the context of delirium

 

Other specified depressive disorder (F32.8)

Depressive symptoms with an explanation of why the symptoms don’t meet criteria for another disorder

Examples of designations:

Recurrent brief depression

Short-duration depressive episode

Depressive episode with insufficient symptoms

 

Unspecified depressive disorder (F32.9)

Symptoms do not meet full criteria for another disorder and no explanation of why

May include situations where there is insufficient information to make another diagnosis

 

Group work

Start out by discussing group norms for communication and workflow, will you use google docs, how will you all agree when the assignment is ready to submit, etc.

Consider assigning group leads for all of the modules you’ll be working on with this group

Group leader should be responsible for creating working documents, submitting assignments, and organizing the work for the week

Two assignments for each week: case study and mini-paper

Mini-paper is due as a DB post by Wednesday, case study is due as an assignment submission by Saturday

 

Student responsibilities

You are responsible for developing a working knowledge and understanding of all of the other diagnoses in the week’s diagnostic category

You are responsible for reviewing all other group mini-paper DB submissions and using them to guide your studying of the other diagnoses for that week

You are responsible for sharing anything you are confused about on your one minute paper for the week

There is no requirement for responses to DB posts, but feel free to reply if you want

 

Other follow ups

Be sure to rotate tasks/jobs within your group so everyone gets a chance to write different sections of the note

Check in at the beginning of each week’s class to review how things went the previous week and whether you need to revise any of your group norms

APA format NOT needed

Citations – do not need to cite the DSM, if you are mentioning statistics/numbers, etc., let us know where you got them from with a link or name of the reference

Paraphrase the information to “teach” your classmates

DSM diagnostic criteria vs. symptom presentation

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal.

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Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process. Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

  1. Evidence-based solution
  2. Nursing intervention
  3. Patient care
  4. Health care agency
  5. Nursing practice

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.