Discussion Response to 2 posts

 Mr. Nguyen is a 58-year-old patient that had septic shock and developed Acute Respiratory Distress Syndrome. He is orally intubated and on a mechanical ventilator. He is paralyzed and sedated.

  • What manifestations might you observe for a patient with ARDS?
  • What complications can Mr. Nguyen develop from being mechanically ventilated?
  • List priority nursing interventions to prevent complications associated with ventilatory support.
  • What interventions can be implemented specifically to prevent the development of Ventilator Acquired Pneumonia (VAP)?
  • You are orienting in the ICU, the nurse you are working with is not implementing the VAP interventions. What would you do?

Initial Post 1:(A.T)

 Severe respiratory distress and low oxygenation are characterizations of ARDS. Manifestations of ARDS include severe dyspnea (difficulty breathing), shallow, rapid breathing, Low oxygen concentrations or hypoxemia, cyanosis (bluish lips or skin as a result of low oxygen levels), reduced lung compliance, increased effort of breathing, bilateral infiltrates seen on the X-ray of the chest, altered mental state as a result of hypoxia. A number of complications can develop for Mr. Nguyen from being on mechanical ventilation, such as ventilator-associated pneumonia (VAP), oxygen toxicity, ventilator-induced lung injury (VILI), barotrauma (high airway pressure-induced lung damage), and ventilator-associated events (VAEs). Priority nursing interventions to prevent complications with ventilatory support include regular evaluation of Mr. Nguyen’s respiratory condition, to avoid self-extubation and lessen agitation continue to administer appropriate sedation and analgesics, keep an eye on and maintain the proper ventilator alarm settings, changing positions frequently to avoid pressure sores and atelectasis, oral hygiene to stop VAP, ensure appropriate ventilation circuit and endotracheal tube hygiene, trials of weaning to evaluate preparedness for extraction. The following are some interventions to avoid ventilator-associated pneumonia (VAP): To lessen the chance of aspiration, raise the bed’s head to a position between 30 and 45 degrees. using chlorhexidine for oral hygiene to stop the growth of microorganisms, routine evaluation of endotracheal tube (ETT) suctioning requirements, To reduce contamination, use a closed suctioning system. To avoid microaspiration, the ETT cuff pressure should be regularly assessed. Reduce the amount of time that patients need mechanical ventilation by using a sedative strategy. Sedation vacations are interrupted every day to evaluate preparation for extubation. It would be imperative to take immediate action if I saw an ICU nurse failing to apply VAP preventative treatments. I would document the circumstance and your activities for my charge nurse or unit manager and If the problem persists, I would talk to my nurse manager or supervisor to make sure that best practices and procedures are followed and maybe consider reeducation for the nurse. In the ICU, patient safety is the top priority. 

Initial Post 2:(B.M.)

Acute Respiratory Distress Syndrome, or ARDS, is a dangerous lung condition that can develop in people who are critically ill and necessitates frequent mechanical ventilation to maintain breathing. One of the symptoms of ARDS identified in Mr. Nguyen was a cluster of respiratory and systemic symptoms. The underlying lung tissue injury and inflammation that obstruct the lungs’ ability to exchange oxygen and carbon dioxide are reflected in these signs and symptoms. Extreme shortness of breath, rapid breathing (tachypnea), cyanosis (bluish skin color), restlessness, fatigue, decreased urine output, tachycardia, low blood pressure (hypotension), and altered mental status are a few of the main symptoms.

When caring for critically ill patients, nurses must consider the potential difficulties of mechanical ventilation, as in Mr. Nguyen’s case. The process of mechanical ventilation requires placing a tube in the patient’s airway in order to deliver oxygen and remove carbon dioxide. Even while treatment can save lives, there are risks and a chance of problems. Ventilator-associated pneumonia (VAP), barotrauma (high air pressure lung damage), ventilator-associated lung injury (VALI), ventilator-associated events (VAE), pressure ulcers, cuff-related tracheal injury, sedation-related complications (such as excessive sedation or inadequate pain management), and infection at the site of the endotracheal tube insertion are a few potential side effects of mechanical ventilation.

Priority nursing interventions include regular evaluations of the patient’s vital signs, oxygen saturation, and respiratory status to gauge how they are responding to mechanical ventilation. Maintaining proper ventilation settings and keeping an eye out for signs of high or low airway pressures are necessary to prevent lung injury and maximize respiratory assistance. The patient must be moved frequently to lessen the chance of pressure sores and to improve lung expansion, which may be compromised in ARDS patients. Regular sedation intervals and assessments of extubating readiness are necessary to avoid prolonged artificial breathing and reduce the risk of sedation-related issues.

In order to prevent the emergence of Ventilator-associated Pneumonia (VAP), nurses should implement specific measures. Among them are regular suctioning of the endotracheal tube to remove secretions and reduce the risk of aspiration, maintaining proper positioning of the endotracheal tube to prevent micro aspiration of gastric contents, and routine oral hygiene using antiseptics to lessen bacterial colonization in the oropharynx. Raising the head of the bed by at least 30 degrees can prevent aspiration, and closely following infection control protocols such hand hygiene and sterile procedures lowers the risk of infection.

While orienting in the ICU, if I see a nurse not using VAP treatments, I would do the following:

I would speak to the nurse politely and respectfully to express my worries on the lack of VAP interventions. I want to underline how important VAP prevention is for patient safety and outcomes, and how it is our responsibility to adhere to best practices in the ICU.I would share my knowledge and understanding of the importance of VAP prevention, emphasizing how it may significantly impact patient recovery and minimize the likelihood of issues. I would give the nurse the tools and knowledge she needs to carry out the VAP interventions, or I would volunteer to help her. Accurate documentation is essential for maintaining a culture of cooperation and stability in our healthcare system and delivering high-quality care to our patients.

ASSESSING NEUROLOGICAL SYMPTOMS

 

A 40 year old female presents with complaint of a headache for one week. Reports a “head cold” 3 weeks ago.  Thought it was getting better, but sinus symptoms are back and even worse.

Describes the headache is located across her forehead; feels like pressure behind my eyes and unable to breathe out of nose. Also feels mucus running down the back of throat.  Pain sometimes severe (8/10) but with acetaminophen reduces to moderate (4/10) and occasionally mild (2/10).  Occasional nonproductive cough.  Feels feverish at times; noted frequent sneezing and no appetite. Bending over seems to make the headache worse.  “Acetaminophen improves my headache, but doesn’t take it away.” Taking Sudafed HCL 120 mg every 12 hours, with some relief. Symptoms are worse in the morning – awakes with a headache. Ranges from 2/10 at its best to 8/10. Difficulty with concentrating at job and feels very tired.

Research on Positive Impact on Nursing Diversity

How does nursing diversity lead to a positive impact on patient outcomes and healthcare quality? 

Please check the rubric ( minimum 6 pages) 

powerpoint presentation

As a practicing professional, you are likely to present educational in-services or training to staff pertaining to quality improvement (QI) measures of safety improvement interventions. Such in-services and training sessions should be presented in a creative and innovative manner to hold the audience’s attention and promote knowledge acquisition and skill application that changes practice for the better. The teaching sessions may include a presentation, audience participation via simulation or other interactive strategy, audiovisual media, and participant learning evaluation.The use of in-services and/or training sessions has positive implications for nursing practice by increasing staff confidence when providing care to specific patient populations. It also allows for a safe and nonthreatening environment where staff nurses can practice their skills prior to a real patient event. Participation in learning sessions fosters a team approach, collaboration, patient safety, and greater patient satisfaction rates in the health care environment (Patel & Wright, 2018).As you prepare to complete the assessment, consider the impact of in-service training on patient outcomes as well as practice outcomes for staff nurses. Be sure to support your thoughts on the effectiveness of educating and training staff to increase the quality of care provided to patients by examining the literature and established best practices.You are encouraged to explore the AONE Nurse Executive Competencies Review activity before you develop the Improvement Plan In-Service Presentation. This activity will help you review your understanding of the AONE Nurse Executive Competencies—especially those related to competencies relevant to developing an effective training session and presentation. This is for your own practice and self-assessment, and demonstrates your engagement in the course.
For this assessment, build on the safety quality Patient Identification Errors in Healthcare and create an agenda and PowerPoint of an educational in-service session that would help a specific staff audience learn, provide feedback, and understand their roles and practice new skills related to the safety improvement plan you created.
The final deliverable for this assessment will be a PowerPoint presentation with detailed presenter’s notes representing the material you would deliver at an in-service session to raise awareness of your chosen safety improvement initiative focusing on a specific patient safety issue and to explain the need for such an initiative. Additionally, you must educate the audience as to their role and importance to the success of the initiative. This includes providing examples and practice opportunities to test out new ideas or practices related to the safety improvement initiative.Be sure that your presentation addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

  • Describe the purpose and goals of an in-service session focusing on a specific patient safety issue.
  • Explain the need for and process to improve safety outcomes related to a specific patient safety issue.
  • Explain to the audience their role and importance of making the improvement plan successful.
  • Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative.
  • Communicate with nurses in a respectful and informative way that clearly presents expectations and solicits feedback on communication strategies for future improvement.

There are various ways to structure an in-service session; below is just one example:

  • Part 1: Agenda and Outcomes.
    • Explain to your audience what they are going to learn or do, and what they are expected to take away.
  • Part 2: Safety Improvement Plan.
    • Give an overview of the current problem focusing on a specific patient safety issue, the proposed plan, and what the improvement plan is trying to address.
    • Explain why it is important for the organization to address the current situation.
  • Part 3: Audience’s Role and Importance.
    • Discuss how the staff audience will be expected to help implement and drive the improvement plan.
    • Explain why they are critical to the success of the improvement plan focusing on a specific patient safety issue.
    • Describe how their work could benefit from embracing their role in the plan.
  • Part 4: New Process and Skills Practice.
    • Explain new processes or skills.
    • Develop an activity that allows the staff audience to practice and ask questions about these new processes and skills.
    • In the notes section of your PowerPoint, brainstorm potential responses to likely questions or concerns.
  • Part 5: Soliciting Feedback.
    • Describe how you would solicit feedback from the audience on the improvement plan and the in-service.
    • Explain how you might integrate this feedback for future improvements.

    Note: Presentation length: There is no required length; use just enough slides to address all the necessary elements. Remember to use short, concise bullet points on the slides and expand on your points in the presenter’s notes. If you use 2 or 3 slides to address each of the parts in the above example, your presentation would be at least 10 slides and no more than 15 slides (not including the title, conclusion, or references slides).

  • Speaker notes: Speaker notes (located under each slide) should reflect what you would actually say if you were delivering the presentation to an audience. This presentation does NOT require audio or a transcript. Another presenter would be able to use the presentation by following the speaker’s notes.
  • APA format: Use APA formatting for in-text citations. Include an APA-formatted reference slide at the end of your presentation.
  • Number of references: Cite a minimum of 3 sources of scholarly or professional evidence to support your assertions. Resources should be no more than 5 years old.

Pathophysiology

  

What assessment data would substantiate the diagnosis of menopause?

What type of therapy would you expect this patient to receive? Why?

Week 6 – ePortfolio: Submission of Artifact and Reflection

NSG 3200 – Health Promotion

Week 6 – ePortfolio: Submission of Artifact and Reflection

Process: For each nursing course in the RN to BSN program, you will upload at least one required artifact to your ePortfolio. The required artifact will be assigned by faculty and identified in the course syllabus.
(Please review the Patient education brochure to complete the BSN Reflection document). Along with the required artifact, students may also select additional course artifacts to demonstrate achievement of outcomes.
For the required artifact, you will complete a Reflection Document analyzing how the assignment demonstrates achievement of the identified PSLO/GEC/Essential.

Reflection Criteria: In the Reflection Document, begin by reviewing the three sets of standards that form the foundation of your RN to BSN program: the Program Student Learning Outcomes (PSLOs), the General Education Competencies (GECs), and the BSN Essentials. Next, select at least one item from each of the three standard sets (PSLOs, GECs, and BSN Essentials) that correlates with the required artifact. In your reflection, do not focus on the entire course as a whole. Instead, focus your reflection on the knowledge, skills and attitudes associated with creating the required course artifact. There is no maximum number of PSLOs, GECs, and BSN Essentials you must select. However, at minimum, you are required to choose one PSLO, one GEC, and one BSN Essential (along with the specific outcomes related to the BSN Essential) that relate to your course artifact. Answer the questions at the end of the Reflection Document to explain/reflect/discuss/analyze how creating the course artifact helped you to demonstrate the PSLO(s), the GEC(s) and the Essential(s) you selected.

BSN Reflection Document

Instructions for completing this document

During your progression in the RN-BSN program, you will use this process of completing and uploading a reflection and artifact in your ePortfolio. This activity is meant to demonstrate how you have achieved the Program Student Learning Outcomes, General Education Competencies, and AACN’s Baccalaureate Essentials through all the work you do in each course.

Please review and click in the checkbox, under each of the headings: Program Student Learning Outcomes (PSLO’s), General Education Competencies (GEC) and the AACN Essentials. Please follow the specific instructions under each of these headings, demonstrated through your assigned course artifact. For each artifact included in your portfolio, submit one reflection form.

Please note that not every artifact will cover all standards, so you may check one or multiple boxes under each of the three standards (PSLO’s, GEC and AACN Baccalaureate Essentials). However, you are required to reflect on at least one of the boxes you check for each standard. Each course reflection contains nine questions except for NSG4150 where students will complete additional questions 10-17 on Art and Science courses; and, NSG 4850 where students answer questions 18-24 only and complete the program reflection section

Once you have completed the Reflection Document, please click on the “Submit” button. This will save your progress and bring you to the list of your Reflection Documents, where you can download a PDF to submit in the assignment dropbox.

NOTE: Each time that you click the “Next” button, your work is saved. If you are at a stopping point in the document, be sure to click on the “Next” button. When you return to the Reflection Document, select “Edit” to make changes or to pick up where you left off.

1. Review your assigned course artifact and check at least one of the following BSN Program Student Learning Outcomes (PSLO) demonstrated through your artifact:

· Synthesize knowledge from the arts and sciences to form a foundation for the practice of professional nursing.

· Provide holistic, culturally competent care for individuals, families, and populations through health promotion and disease prevention across the lifespan and healthcare continuum.

· Integrate professional values and behaviors when delivering standards-based nursing care to diverse patients and populations.

· Develop leadership skills to provide and continuously improve the delivery of safe, patient-centered quality healthcare.

· Incorporate best practices and the most current evidence when using clinical reasoning to make practice decisions.

· Incorporate the use of information systems and technology in order to communicate, manage knowledge, mitigate error, and support decision-making.

· Integrate effective communication and collaboration skills to improve patient satisfaction and health outcomes.

2. Discuss one PSLO that you are reflecting on and explain how the assigned course artifact demonstrates your progression toward achieving the PSLO you checked above. Relate two class activities that helped you achieve the selected PSLO.

3. Analyze what you have learned by completing the assigned course artifact. What areas of growth or future learning needs must be met to meet the PSLO(s) for your baccalaureate education?

4. Review the assigned course artifact and check at least one of the following General Education Competencies (GEC) demonstrated through your artifact:

· Cultural Competence: Learners will demonstrate an understanding of philosophies that represent social, emotional, and behavioral attributes of society and individuals.

· Communication: Learners will demonstrate an understanding of the views of others and communicate in a professional manner.

· Critical Thinking: Learners will demonstrate the ability to draw conclusions based on evidence and consider prior knowledge, context, and perspectives in predicting implications or consequences.

· Information Literacy: Learners will demonstrate the ability to identify, evaluate and apply information to accomplish a specific purpose.

· Quantitative Literacy: Learners will demonstrate the ability to report, calculate, and analyze quantitative date.

· Scientific Literacy: Learners will gain the ability to read with understanding scientific content and engage in a dialogue about scientific issues.

5. Select one GEC and reflect on it by making specific reference to the course and your artifact as you explain how the assigned course artifact demonstrates your progression toward achieving the GEC you checked above. Relate two class activities that helped you achieve the selected GEC.

6. Review the assigned course artifact and check at least one standard listed under the nine BSN Essentials demonstrated through your artifact (only one standard under one BSN essential is required to be selected):

Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice.

· Physical, natural, life science, math, social sciences.

· Fine art, performing art, humanities

Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety.

· Demonstrate knowledge and skills in leadership.

· Describe quality improvement.

· Advocate for patient safety.

· Demonstrate caring, effective communication with all constituents.

· Describe and navigate in complex organizational systems.

Essential III: Scholarship for Evidence Based Practice (Professional nursing practice is grounded in the translation of current evidence into one's practice).

· Provide evidence-based nursing interventions.

· Delineate interrelationships among theory, practice, research.

· Describe the elements of the research process and application.

· Advocate for protection of human subjects.

· Evaluate credibility of information.

· Participate in retrieval, appraisal, and synthesis of evidence.

Essential IV: Information Management and Application of Patient Care Technology.

· Understand information management and the impact upon patient outcomes.

· Employ a variety of patient care technologies.

· Demonstrate effectiveness in telecommunication technologies.

· Apply decision-making tools to support safe practice.

· Use CIS systems to document interventions and improve patient outcomes.

· Evaluate data to inform the delivery of care.

· Maintain ethical standards related to data and patient rights.

· Participate in evaluation of information systems.

Essential V: Health Care Policy, Finance, and Regulatory Environments

· Understand healthcare policies and financial implications.

· Explore regulatory environments and the impact on healthcare.

· Understand global trends.

· Be familiar with legislative and regulatory process in healthcare.

· Explore socio-cultural, economic, legal influence on practice.

· Describe role of regulatory agencies and impact on patient outcome, quality, and practice.

· Discuss healthcare policy related to access, equity, affordability, and social justice.

· Use an ethical framework to evaluate healthcare policies.

· Participate in political processes that influence healthcare policy.

Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Care Outcomes

· Understand multi-disciplinary roles of the healthcare team.

· Employ effective communication to resolve conflict, foster teamwork.

· Advocate for high quality care as a member of the healthcare team.

Essential VII: Clinical Prevention and Population Health.

· Assess protective and predictive factors, including genetics, which influence health.

· Assess health from a holistic perspective, including values, attitudes of families, groups, communities, and populations.

· Promote health, manage illness.

· Use EBP to guide health teaching, screening, and counseling, throughout lifespan.

· Assess health, healthcare, and emergency preparedness needs of a defined population.

· Develop an intervention plan that considers health, resources, prevention of illness, injury, disability, and premature death.

· Participate in prevention and population-focused interventions related to effectiveness, efficiency, cost-effectiveness, and equity.

· Advocate for social justice, including health of vulnerable populations.

Essential VIII: Professionalism and Professional Values

· Demonstrate professional standards of moral, ethical, and legal conduct.

· Exhibit accountability, role modeling professional values, professionalism, and integrity.

· Identify personal, professional, and environmental risks that impact personal and professional choices.

· Examine practice for promotion of social justice.

· Articulate value of professional growth and development and lifelong learning.

· Protect patient privacy and confidentiality.

Essential IX: Baccalaureate Generalist Nursing Practice.

· Demonstrate caring and health techniques that promote a therapeutic nurse-patient relationship.

· Conduct assessment across populations and lifespan.

· Recognize constructs of genetics on health, prevention, screening, diagnostics, prognostics, treat.

· Provide holistic care across the lifespan.

· Communicate effectively with patients, families, and healthcare team.

· Provide compassionate, patient-centered, evidence-based care.

· Provide nursing care based on evidence that contributes to safe and high-quality patient outcomes.

7. Select one of the BSN Essentials you have chosen and reflect on the relationship between the essential chosen, your learning, and the course artifact. Relate two class activities that helped you achieve the selected BSN Essential.

8. Describe what you have learned by completing the assigned course artifact. What areas of growth or future learning needs must be met to meet all of the program learning outcomes for your baccalaureate education?

9. Describe how your learning and achievement of these standards will impact your future role as a BSN nurse.

Grading of ePortfolio Assignments

Each ePortfolio assignment will be a graded using an assigned grading rubric.

A grade of 100% is the required passing score for all ePortfolio assignments
. Refer to the assignment rubric. If a revision is required to achieve a passing score, resubmission of an ePortfolio assignment must be completed within 72 hours of receiving your instructor feedback. Students are to refer to the ePortfolio tutorials for further guidance as needed.

All ePortfolio course requirements must be met in order to receive a passing end of course grade. As per the RN- BSN program incomplete policy, students have two weeks to submit the required coursework or the incomplete will be changed to a failing grade (F).

ePortfolio Rubric

Criteria

Excellent

Submission of URL/Link to ePortfolio Home Page

• URL (link) to the ePortfolio is submitted to the assignment drop box. Submitted URL leads directly to the ePortfolio Home Page. The ePortfolio contents are viewable.

15 pts

Excellent

The ePortfolio submission meets all criteria.

Home Section

• Welcome page contains a welcome message and optional upload of a professional photograph.

• Welcome page contains a professional biography to include a summary of work experience, academic background, and professional goals.

Excellent.
The ePortfolio submission meets all criteria.

15 pts

Creation of Course Section (e.g., NSG 3200)

· Course Section (e.g., NSG 3200) is present.

· Course Section (e.g., NSG 3200) is labeled using

correct prefix and number.

Excellent.
The ePortfolio submission meets all criteria.

10 pts

Creation of Course Artifact Page and Upload of Assigned Course Artifact

· One course artifact page is present in the current course section (e.g., NSG 3200) and labeled as Artifact.

· One assigned course artifact document is uploaded to the current course artifact page.

· Course artifact was not linked from Dropbox

submission.

Excellent.
The ePortfolio submission meets all criteria.

15 pts

Completion of Reflection

· 1 selection is made in each subsection (the PSLOs, GECs, BSN Essentials) of the reflection form.

· All narrative prompts are completely addressed.

· One course reflection page is present in

the current course section (e.g., NSG 3200) and

labeled as Reflection.

· One completed PDF course reflection document is

uploaded to the current course reflection page.

Excellent.
The ePortfolio submission meets all criteria.

25 pts

ePortfolio Organization

· Free of blank or duplicate course sections.

· Free of blank or duplicate pages within the course

section(s).

· Evidence of previous submissions organized in

one ePortfolio.

Excellent.
The ePortfolio submission meets all criteria.

20 pts

Totals
*100% required to pass

100

Consider a population health topic that rises to the presidential agenda level.

 Consider a population health topic that rises to the presidential agenda level. Which social determinant most affects this health issue? How did two recent presidents handle the problem? What would you do differently? 

Womens Health Brochure

Women’s Health Brochure

Module 01 Content

1.

Top of Form

Competency

Identify multidimensional nursing care strategies for clients with reproductive system disorders.

Scenario

You work in a gynecological office, and your office has been asked to participate in a women’s health fair. The focus of the fair is health promotion. Preventative screening for female reproductive disorders is vital to identify and treat rapidly to produce the best patient outcomes. Preventative screening includes a mammogram and Pap smear and should be performed based on recommended age and associated risk factors. To promote preventative screening, your office will be creating brochures to distribute at the health fair.

Instructions

Design a women’s health brochure by choosing one of the female reproductive disorders covered in this module. In the brochure, include the following:

· Overview of the disease including disease process, signs and symptoms, and risk factors

· Preventative screening

· Diagnostics tests

· Treatment

· Multidimensional nursing care interventions

Bottom of Form

Ipsum

Select a nursing theorist of choice and research him/her. Identify their key contribution to nursing and explain its importance in healthcare. 500 – 550 words and 3 or more scholarly sources.

Discussion Post-

Describe the role of each component of the ECG in the heart’s contraction: the P wave, the PR interval, the QRS complex, the ST segment, the T wave, and the QT interval. What is the difference between artifact and dysrhythmia? How can you reduce artifacts? What are some situations that can occur if artifact is not reduced or eliminated?

You are working in the Telemetry Unit. The nurse “watching” the monitors is reading a magazine. She constantly turns off an alarm that looks a lot like Ventricular Fibrillation. She tells you that it is not a dysrhythmia, it is just artifact. What do you think about her actions? What is the worst case scenario in this situation? What would you do?

Must be a minimum of 250 words.